Active NPI
Paul Timothy Crosby, LICSW MSW
- Clinical Social Worker
- Marblehead, MA
National Provider Identifier
1780779686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW1028281
- Practice address
- 66 Clifton Avenue
Marblehead, MA 01945 - Phone
- (781) 631-8273
- Fax
- (781) 631-7264
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW1028281 | MA | Primary |
Addresses
Primary practice location
66 Clifton Avenue
Marblehead, MA 01945
Mailing address
26 Greenwood Rd
Peabody, MA 01960
Phone (978) 532-6947
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW1028281 | MA | MD | Clinical Social Worker |
| 102828 | MA | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1780779686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 GREENWOOD RD",
"city": "PEABODY",
"state": "MA",
"postal_code": "01960",
"telephone_number": "978-532-6947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 CLIFTON AVENUE",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "01945",
"telephone_number": "781-631-8273",
"fax_number": "781-631-7264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSBY",
"first_name": "PAUL",
"middle_name": "TIMOTHY",
"name_prefix": "Mr.",
"credential": "LICSW MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "SW1028281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marblehead, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.