Individual provider Active NPI

Elizabeth Boardman Harris

  • Social Worker
  • Waltham, MA
National Provider Identifier
1760964118
Registry record updated Sep 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
117999 Issued in MA
Practice address
60 Hickory Drive 4TH Floor
Waltham, MA 02451
Phone
(800) 571-1918
NPI assigned
Sep 2, 2018
Last updated
Sep 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 117999 MA Primary

Addresses

Primary practice location

60 Hickory Drive 4TH Floor
Waltham, MA 02451

Mailing address

59 Linden St Unit 1610
Taunton, MA 02780
Phone (617) 791-0621

Other practice location 1

59 Linden St Unit 1610
Taunton, MA 02780
Phone (617) 791-0621

Other names 1

  • Liz Boardman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702000578 MA Practitioner - Clinical Social Worker 6103150768 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renz Counseling, LLCGroup PAC ID 0042533259, 11 clinicians

Practice addresses (Care Compare)

378 Page St
Suite 6
Stoughton, MA 02072-1124
Phone (339) 364-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arbour Elder Services, Inc. CurrentSince May 21, 2019 Accepting new patients
Hri Clinics, Inc. CurrentSince May 21, 2019 Accepting new patients
Arbour Elder Services, Inc. CurrentSince May 21, 2019 Accepting new patients
Renz Counseling, LLC CurrentSince Sep 26, 2023 Accepting new patients
Hri Clinics Inc CurrentSince May 21, 2019 Accepting new patients

Locations

14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676

1032 Turnpike St
Ste 204
Canton, MA 02021
Phone (339) 364-8080

100 Ledgewood Pl
Ste 202
Rockland, MA 02370
Phone (781) 871-6500

378 Page St
Ste 6
Stoughton, MA 02072
Phone (339) 364-8080

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535846400000",
    "number": "1760964118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 LINDEN ST UNIT 1610",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "02780",
            "telephone_number": "617-791-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HICKORY DRIVE 4TH FLOOR",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "800-571-1918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Linden St Unit 1610",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "02780",
            "country_code": "US",
            "telephone_number": "617-791-0621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELIZABETH",
        "middle_name": "BOARDMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-02",
        "last_updated": "2018-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "117999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZ",
            "last_name": "BOARDMAN",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.