Active NPI
Elisabeth Ellis Waingrow, MSW, LICSW
- Mental Health Counselor
- Newton Highlands, MA
National Provider Identifier
1811045537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 104093
- Practice address
- 24 Lincoln St
Newton Highlands, MA 02461-1524 - Phone
- (617) 244-8132
- NPI assigned
- Jan 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 104093 | MA | Primary |
Addresses
Primary practice location
24 Lincoln St
Newton Highlands, MA 02461-1524
Mailing address
P.O. Box 610094
Newton Highlands, MA 02461-0094
Phone (617) 244-8132
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01953 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104093 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811045537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 610094",
"city": "NEWTON HIGHLANDS",
"state": "MA",
"postal_code": "024610094",
"telephone_number": "617-244-8132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 LINCOLN ST",
"city": "NEWTON HIGHLANDS",
"state": "MA",
"postal_code": "024611524",
"telephone_number": "617-244-8132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAINGROW",
"first_name": "ELISABETH",
"middle_name": "ELLIS",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "104093",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "P01953",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton Highlands, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.