Individual provider Active NPI

Maryanne R Ludwig, MSW, LICSW

  • Clinical Social Worker
  • Sudbury, MA
National Provider Identifier
1790269397
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113069 Issued in MA
Practice address
24 Magnolia Rd
Sudbury, MA 01776-2669
Phone
(617) 512-5573
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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 113069 MA Primary

Addresses

Primary practice location

24 Magnolia Rd
Sudbury, MA 01776-2669

Mailing address

375 Totten Pond Rd Ste 100
Waltham, MA 02451-2026
Phone (781) 894-5330

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113069MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1790269397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 TOTTEN POND RD STE 100",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024512026",
            "telephone_number": "781-894-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAGNOLIA RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017762669",
            "telephone_number": "617-512-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "MARYANNE",
        "middle_name": "R",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sudbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.