Active NPI
Wendy Wyman
- Social Worker
- Gloucester, MA
National Provider Identifier
1851873715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 120020-SW-LICSW
- Practice address
- 4R Blackburn Ctr
Gloucester, MA 01930-2268 - Phone
- (978) 281-0252
- Fax
- (978) 282-5580
- NPI assigned
- Sep 6, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 120020-SW-LICSW | MA | Primary |
Addresses
Primary practice location
4R Blackburn Ctr
Gloucester, MA 01930-2268
Mailing address
351 Concord St
Gloucester, MA 01930-1535
Phone (978) 290-7657
Other practice location 1
Day by Day Adult Care, Inc.
4R Blackburn Center
Gloucester, MA 01930
Phone (978) 281-0252
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 |
|---|---|---|---|
| 120020-SW-LICSW | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1851873715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 CONCORD ST",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019301535",
"telephone_number": "978-290-7657",
"fax_number": "978-282-5580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4R BLACKBURN CTR",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019302268",
"telephone_number": "978-281-0252",
"fax_number": "978-282-5580"
}
],
"practiceLocations": [
{
"address_1": "Day by Day Adult Care, Inc.",
"address_2": "4R Blackburn Center",
"address_purpose": "LOCATION",
"city": "Gloucester",
"state": "MA",
"postal_code": "01930",
"country_code": "US",
"telephone_number": "978-281-0252",
"fax_number": "978-282-5580",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WYMAN",
"first_name": "WENDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-06",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "120020-SW-LICSW",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloucester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.