Individual provider Active NPI

Marc Engram, LICSW

  • Clinical Social Worker
  • Northampton, MA
National Provider Identifier
1821186693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1023561 Issued in MA
Practice address
200 Main St Ste 2a
Northampton, MA 01060-3170
Phone
(413) 587-0444
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1023561 MA Primary

Addresses

Primary practice location

200 Main St Ste 2a
Northampton, MA 01060-3170

Mailing address

292 Pelham Hill Rd
Shutesbury, MA 01072-9748
Phone (413) 587-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210000126 MA Practitioner - Clinical Social Worker 9830083021 Practice locations: Shutesbury, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

292 Pelham Hill Rd
Shutesbury, MA 01072-9748
Phone (413) 992-7667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023561MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Springfield Counseling, PC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821186693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 PELHAM HILL RD",
            "city": "SHUTESBURY",
            "state": "MA",
            "postal_code": "010729748",
            "telephone_number": "413-587-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN ST STE 2A",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603170",
            "telephone_number": "413-587-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGRAM",
        "first_name": "MARC",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1023561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.