Individual provider Active NPI

Myrtise Maurice, LICSW

  • Clinical Social Worker
  • Hyde Park, MA
National Provider Identifier
1871809111
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
181 Fairmount Ave
Hyde Park, MA 02136-3505
Phone
(617) 230-5210
NPI assigned
Aug 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

181 Fairmount Ave
Hyde Park, MA 02136-3505

Mailing address

1525 Blue Hill Ave
Boston, MA 02126-1702
Phone (617) 356-8242

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

Practice roles

OrganizationSpecialtyStatusNew patients
Perspectives Health Services, LLC Clinical Current Accepting new patients
Priority Professional Care,LLC PastSince Apr 5, 2016 Accepting new patients

Locations

867 Boylston St
Fl 5
Boston, MA 02116
Phone (617) 221-3202

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1871809111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 BLUE HILL AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021261702",
            "telephone_number": "617-356-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 FAIRMOUNT AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363505",
            "telephone_number": "617-230-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICE",
        "first_name": "MYRTISE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.