Individual provider Active NPI

Sandra Yudilevich Espinoza, PHD

  • Clinical Social Worker
  • Marblehead, MA
National Provider Identifier
1952821092
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116172 Issued in MA
Practice address
23 Pleasant St Apt 4
Marblehead, MA 01945-3462
Phone
(706) 248-9275
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 116172 MA Primary

Addresses

Primary practice location

23 Pleasant St Apt 4
Marblehead, MA 01945-3462

Mailing address

23 Pleasant St Apt 4
Marblehead, MA 01945-3462
Phone (706) 248-9275

Other identifiers 1

IdentifierTypeStateIssuer
116172OtherMASOCIAL WORK LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719000232 MA Practitioner - Clinical Social Worker 0547530909 Practice locations: Marblehead, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 Pleasant St
Apt 4
Marblehead, MA 01945-3462
Phone (706) 248-9275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952821092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PLEASANT ST APT 4",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453462",
            "telephone_number": "706-248-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 PLEASANT ST APT 4",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453462",
            "telephone_number": "706-248-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDILEVICH ESPINOZA",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "116172",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

Verify at the official NPI Registry.