Individual provider Active NPI

George R Ingham, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1922264969
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1020911 Issued in MA
Practice address
330 Mount Auburn St
Cambridge, MA 02138-5502
Phone
(617) 499-5054
Fax
(617) 499-5465
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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 1020911 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Cambridge, MA 02138-5502

Mailing address

330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502
Phone (617) 499-5054

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
Mount Auburn Hospital Past Accepting new patients

Organizations & group practices 1

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1922264969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "CLARK 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-499-5054",
            "fax_number": "617-499-5465"
        },
        {
            "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": "617-499-5054",
            "fax_number": "617-499-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGHAM",
        "first_name": "GEORGE",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1020911",
            "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 Mar 24, 2009; 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.