Active NPI
Maevon Cody-Mackechnie
- Clinical Social Worker
- Brockton, MA
National Provider Identifier
1851672745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MC13277
- Practice address
- 940 Belmont St
Brockton, MA 02301-5596 - Phone
- (774) 826-2217
- NPI assigned
- Sep 6, 2011
- Last updated
- Jun 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC16192 | ME | |
| Clinical Social Worker | 1041C0700X | LICSW123499 | MA | |
| Clinical Social Worker | 1041C0700X | MC13277 | ME | Primary |
Addresses
Primary practice location
940 Belmont St
Brockton, MA 02301-5596
Mailing address
940 Belmont St
Brockton, MA 02301-5596
Phone (774) 826-2217
Other practice location 1
470 Forest Ave
Portland, ME 04101-2009
Phone (207) 774-3570
Other practice location 2
1437 S Belcher Rd
Clearwater, FL 33764
Phone (727) 524-4464 ext. 1255
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW123499 | MA | MD | Clinical Social Worker |
| LC16192 | ME | MD | Clinical Social Worker |
| MC13277 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1851672745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "774-826-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "774-826-2217"
}
],
"practiceLocations": [
{
"address_1": "470 Forest Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041012009",
"country_code": "US",
"telephone_number": "207-774-3570",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1437 S Belcher Rd",
"address_purpose": "LOCATION",
"city": "Clearwater",
"state": "FL",
"postal_code": "33764",
"country_code": "US",
"telephone_number": "727-524-4464 x1255",
"fax_number": "727-538-7272",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CODY-MACKECHNIE",
"first_name": "MAEVON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC16192",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "LICSW123499",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "MC13277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.