Active NPI
Patricia Axsom O'Brien, M.DIV., LICSW
- Clinical Social Worker
- South Hamilton, MA
National Provider Identifier
1801030416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1023975
- Practice address
- 639 Bay Rd
South Hamilton, MA 01982-1006 - Phone
- (978) 309-9660
- NPI assigned
- Apr 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 35738 | TX | |
| Clinical Social Worker | 1041C0700X | 1023975 | MA | Primary |
Addresses
Primary practice location
639 Bay Rd
South Hamilton, MA 01982-1006
Mailing address
P.O. Box 70
Hamilton, MA 01936
Phone (978) 309-9660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 30, 2020 through May 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35738 | TX | MD | Endodontist |
| 1023975 | MA | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1801030416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 70",
"city": "HAMILTON",
"state": "MA",
"postal_code": "01936",
"telephone_number": "978-309-9660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "639 BAY RD",
"city": "SOUTH HAMILTON",
"state": "MA",
"postal_code": "019821006",
"telephone_number": "978-309-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "PATRICIA",
"middle_name": "AXSOM",
"credential": "M.DIV., LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-27",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "35738",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1023975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hamilton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.