Individual provider Active NPI

Laurel E Kenworthy, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1770922049
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116610 Issued in MA
Practice address
330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502
Phone
(617) 499-5054
Fax
(617) 499-5465
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 116610 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502

Mailing address

330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502
Phone (617) 499-5054

Other practice location 1

41 Mall Rd
Burlington, MA 01805-5502
Phone (781) 744-8000

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
I20131121001392 MA Practitioner - Clinical Social Worker 1254567241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8451

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116610MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Mar 14, 2023 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1770922049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "CLARK 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-499-5054",
            "fax_number": "617-499-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "CLARK 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-499-5054",
            "fax_number": "617-499-5465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018055502",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENWORTHY",
        "first_name": "LAUREL",
        "middle_name": "E",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.