Active NPI
Mary H. Urban, MSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1871655464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 104513
- Practice address
- 210 Fisher Ave
Boston, MA 02120-3340 - Phone
- (617) 730-9595
- Fax
- (617) 277-4341
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 104513 | MA | Primary |
Addresses
Primary practice location
210 Fisher Ave
Boston, MA 02120-3340
Mailing address
210 Fisher Ave
Boston, MA 02120-3340
Phone (617) 730-9595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PO2646 | Other | MA | BLUE CROSSBLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
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": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1871655464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 FISHER AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203340",
"telephone_number": "617-730-9595",
"fax_number": "617-277-4341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 FISHER AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203340",
"telephone_number": "617-730-9595",
"fax_number": "617-277-4341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URBAN",
"first_name": "MARY",
"middle_name": "H.",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "104513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSSBLUESHIELD",
"identifier": "PO2646",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
- Tyler James Uppstrom, MD
- Jenica N. Upshaw, MD
- Upstream Mental Health a Psychological Professional Corporation
- Upward Health of Massachusetts PC
- Urban Eye MD Associates, P.C
- Urbano Psychological & Wellness Services, LLC
- Alessandra Urbano, PH.D.
- Sarah Margaret Urbut, MD
- Danielle Urciullo, MSW
- Pedro Urday, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.