Active NPI
Abigail Joy Reynolds, LCSW
- Clinical Social Worker
- Somerville, MA
National Provider Identifier
1780816454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- M-07094
- Practice address
- 111 South St
Somerville, MA 02143-4297 - Phone
- (781) 223-2342
- Fax
- (617) 591-0239
- NPI assigned
- Aug 14, 2009
- Sex
- Female
- 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 | M-07094 | NM | Primary |
Addresses
Primary practice location
111 South St
Somerville, MA 02143-4297
Mailing address
111 South St
Somerville, MA 02143-4297
Phone (781) 223-2342
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 |
|---|---|---|---|
| M-07094 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Community Care | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Dedham, MA
- NPI 1386195030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1780816454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 SOUTH ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021434297",
"telephone_number": "781-223-2342",
"fax_number": "617-591-0239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SOUTH ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021434297",
"telephone_number": "781-223-2342",
"fax_number": "617-591-0239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "ABIGAIL",
"middle_name": "JOY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-14",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "M-07094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.