Individual provider Active NPI

Emily Brooke Wasser

  • Clinical Social Worker
  • Andover, MA
National Provider Identifier
1912360934
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
225515 Issued in MA
Practice address
40 Shattuck Rd Ste 250
Andover, MA 01810-2492
Phone
(978) 222-3121
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 Worker 1041C0700X 225515 MA Primary

Addresses

Primary practice location

40 Shattuck Rd Ste 250
Andover, MA 01810-2492

Mailing address

15 Oakland St Apt 3
Brighton, MA 02135-2985
Phone (603) 667-5894

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
I20200210000505 MA Practitioner - Clinical Social Worker 5799111878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

40 Shattuck Rd
Suite 250
Andover, MA 01810-2492
Phone (978) 222-3121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
225515MAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Nov 1, 2025 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. Current Accepting new patients
Optum Behavioral Care of Connecticut, P.C. Clinical CurrentSince Nov 1, 2025 Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

Organizations & group practices 3

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1912360934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OAKLAND ST APT 3",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352985",
            "telephone_number": "603-667-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SHATTUCK RD STE 250",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102492",
            "telephone_number": "978-222-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSER",
        "first_name": "EMILY",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "225515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.