Individual provider Active NPI

Shannon McCarthy, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1841483583
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024263 Issued in MA
Practice address
124 Harvard St
Brookline, MA 02446-6478
Phone
(617) 645-6448
NPI assigned
Aug 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 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 1024263 MA Primary

Addresses

Primary practice location

124 Harvard St
Brookline, MA 02446-6478

Mailing address

119 Walk Hill St
Jamaica Plain, MA 02130-4147
Phone (617) 645-6448

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1841483583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WALK HILL ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304147",
            "telephone_number": "617-645-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466478",
            "telephone_number": "617-645-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.