Active NPI
Jessie Moynihan, LICSW
- Social Worker
- Boston, MA
National Provider Identifier
1922589837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 110839-SW-LICSW
- Practice address
- 595 Harrison Ave
Boston, MA 02118-2420 - Phone
- (617) 426-2855
- NPI assigned
- Aug 28, 2018
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 110839-SW-LICSW | MA | Primary |
Addresses
Primary practice location
595 Harrison Ave
Boston, MA 02118-2420
Mailing address
178 Tremont St
Boston, MA 02111-1006
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
| License | State | Type | Specialty |
|---|---|---|---|
| 110839-SW-LICSW | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1922589837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 TREMONT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 HARRISON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182420",
"telephone_number": "617-426-2855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYNIHAN",
"first_name": "JESSIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-28",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "110839-SW-LICSW",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.