Active NPI
Shelly Watson, MSW, LICSW
- Clinical Social Worker
- Worcester, MA
National Provider Identifier
1942518741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1028443
- Practice address
- 44 Front St
Worcester, MA 01608-1733 - Phone
- (508) 799-2934
- NPI assigned
- Sep 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1028443 | MA | Primary |
Addresses
Primary practice location
44 Front St
Worcester, MA 01608-1733
Mailing address
7 Zenith Dr
Worcester, MA 01602-3244
Phone (508) 887-2735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 4, 2022 through Apr 4, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1028443 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284508800000",
"number": "1942518741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 ZENITH DR",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016023244",
"telephone_number": "508-887-2735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 FRONT ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081733",
"telephone_number": "508-799-2934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "SHELLY",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2010-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1028443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.