Individual provider Active NPI

Marylou M Butero, MSW

  • Clinical Social Worker
  • Dartmouth, MA
National Provider Identifier
1861752974
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1017543 Issued in MA
Practice address
15 Eighth Green Dr
Dartmouth, MA 02747-5214
Phone
(774) 451-5597
NPI assigned
May 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 376 MA
Clinical Social Worker 1041C0700X 1017543 MA Primary

Addresses

Primary practice location

15 Eighth Green Dr
Dartmouth, MA 02747-5214

Mailing address

15 Eighth Green Dr
Dartmouth, MA 02747-5214
Phone (774) 451-5597

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
I20121026000019 MA Practitioner - Clinical Social Worker 1759531841 Practice locations: Fall River, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1311 Bedford St
Fall River, MA 02723-2637
Phone (508) 685-3057

15 8TH Green Dr
Dartmouth, MA 02747-5214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
376MAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1861752974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EIGHTH GREEN DR",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027475214",
            "telephone_number": "774-451-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EIGHTH GREEN DR",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027475214",
            "telephone_number": "774-451-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTERO",
        "first_name": "MARYLOU",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "376",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1017543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.