Organization Active NPI

Wintergreen Therapy Associates PLLC

  • Clinical Social Worker
  • Chestnut Hill, MA
National Provider Identifier
1912820572
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WINTERGREEN THERAPY ASSOCIATES PLLC
Practice address
100 Risley Rd
Chestnut Hill, MA 02467-3276
Phone
(617) 515-9472
NPI assigned
Jul 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Miranda Simon
Title
Owner
Phone
(671) 515-9472

Specialties & licenses 1

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

Addresses

Primary practice location

100 Risley Rd
Chestnut Hill, MA 02467-3276

Mailing address

100 Risley Rd
Chestnut Hill, MA 02467-3276

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1912820572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RISLEY RD",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RISLEY RD",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673276",
            "telephone_number": "617-515-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTERGREEN THERAPY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "671-515-9472"
    },
    "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 Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.