Individual provider Active NPI

Taya Zbell Cloonan, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1932680758
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111774 Issued in MA
Practice address
51 Blossom St
Boston, MA 02114-2601
Phone
(617) 371-4819
Fax
(617) 371-4827
NPI assigned
Aug 29, 2018
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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 111774 MA Primary

Addresses

Primary practice location

51 Blossom St
Boston, MA 02114-2601

Mailing address

51 Blossom St
Boston, MA 02114-2601
Phone (617) 371-4819

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
111774MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1932680758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BLOSSOM ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142601",
            "telephone_number": "617-371-4819",
            "fax_number": "617-371-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BLOSSOM ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142601",
            "telephone_number": "617-371-4819",
            "fax_number": "617-371-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOONAN",
        "first_name": "TAYA",
        "middle_name": "ZBELL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111774",
            "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 29, 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.

Verify at the official NPI Registry.