Individual provider Active NPI

Matthew Arre Stella, LICSW

  • Clinical Social Worker
  • Salem, MA
National Provider Identifier
1902982614
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115818 Issued in MA
Practice address
30 Church St
Suite 205
Salem, MA 01970-3714
Phone
(617) 820-7110
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4971402-3502 UT
Clinical Social Worker 1041C0700X 115818 MA Primary

Addresses

Primary practice location

30 Church St
Suite 205
Salem, MA 01970-3714

Mailing address

22 Oliver St
Salem, MA 01970-3818
Phone (617) 820-7110

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
115818MAMDClinical Social Worker
4971402-3502UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1902982614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OLIVER ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703818",
            "telephone_number": "617-820-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHURCH ST",
            "address_2": "SUITE 205",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703714",
            "telephone_number": "617-820-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLA",
        "first_name": "MATTHEW",
        "middle_name": "ARRE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "4971402-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.