NPIMap

Individual provider Active NPI

Mark A. Godin, LICSW

  • Clinical Social Worker
  • Peabody, MA
National Provider Identifier
1821320375
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105879 Issued in MA
Practice address
1R Newbury St
Suite 205
Peabody, MA 01960-3864
Phone
(978) 535-1608
NPI assigned
Feb 9, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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 105879 MA Primary

Addresses

Primary practice location

1R Newbury St
Suite 205
Peabody, MA 01960-3864

Mailing address

50 Plum St
S Hamilton, MA 01982-1916
Phone (339) 927-1124

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
105879MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Clinicians Group LLC Past Accepting new patients
Northeast Senior Options LLC 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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1821320375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PLUM ST",
            "city": "S HAMILTON",
            "state": "MA",
            "postal_code": "019821916",
            "telephone_number": "339-927-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1R NEWBURY ST",
            "address_2": "SUITE 205",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603864",
            "telephone_number": "978-535-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODIN",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.