Individual provider Active NPI

Joyce Shapiro-Ellowitz, LICSW

  • Clinical Social Worker
  • Gardner, MA
National Provider Identifier
1821190844
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1025894 Issued in MA
Practice address
486 Chestnut Street
Gardner, MA 01440
Phone
(978) 630-3225
Fax
(978) 630-3226
NPI assigned
Sep 1, 2006
Sex
Female
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 1025894 MA Primary

Addresses

Primary practice location

486 Chestnut Street
Gardner, MA 01440

Mailing address

25 Westbrook Road
Worcester, MA 01602
Phone (978) 870-8542

Other identifiers 1

IdentifierTypeStateIssuer
1854917MedicaidMA

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
I20041222000044 MA Practitioner - Clinical Social Worker 0840258828 Practice locations: Westminster, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 Village Inn Rd
Westminster, MA 01473-1660
Phone (978) 870-8542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wachusett Family Dental, LLC PastSince Feb 24, 2022 Accepting new patients
Heywood Medical Group Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821190844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WESTBROOK ROAD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01602",
            "telephone_number": "978-870-8542",
            "fax_number": "978-630-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 CHESTNUT STREET",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "01440",
            "telephone_number": "978-630-3225",
            "fax_number": "978-630-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO-ELLOWITZ",
        "first_name": "JOYCE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1854917",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.