Individual provider Active NPI

John T Greenhalgh Jr., LICSW

  • Clinical Social Worker
  • North Billerica, MA
National Provider Identifier
1922695196
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119653 Issued in MA
Practice address
216 Rangeway Rd Unit 162
North Billerica, MA 01862-2024
Phone
(978) 621-4479
NPI assigned
Dec 22, 2020
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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 119653 MA Primary

Addresses

Primary practice location

216 Rangeway Rd Unit 162
North Billerica, MA 01862-2024

Mailing address

PO Box 387
Billerica, MA 01821-0387
Phone (978) 621-4479

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
119653MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1922695196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018210387",
            "telephone_number": "978-621-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 RANGEWAY RD UNIT 162",
            "city": "NORTH BILLERICA",
            "state": "MA",
            "postal_code": "018622024",
            "telephone_number": "978-621-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENHALGH",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Billerica, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.