Active NPI
Alexis Sholtis, LICSW
- Clinical Social Worker
- Cambridge, MA
National Provider Identifier
1902427768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 123109
- Practice address
- 330 Mount Auburn St
Cambridge, MA 02138-5502 - Phone
- (617) 499-5811
- Fax
- (617) 499-5419
- NPI assigned
- May 4, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 123109 | MA | Primary |
Addresses
Primary practice location
330 Mount Auburn St
Cambridge, MA 02138-5502
Mailing address
254 Calvary St
Waltham, MA 02453-8366
Phone (860) 921-3493
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 |
|---|---|---|---|
| 123109 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1902427768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 CALVARY ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024538366",
"telephone_number": "860-921-3493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MOUNT AUBURN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385502",
"telephone_number": "617-499-5811",
"fax_number": "617-499-5419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOLTIS",
"first_name": "ALEXIS",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-04",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "123109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.