NPIMap

Organization Active NPI

Corf Psychology Group LLC

  • Clinical Social Worker
  • Ipswich, MA
National Provider Identifier
1962013235
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CORF PSYCHOLOGY GROUP LLC
Doing business as
Corf Psychology Group LLC
Practice address
4 S Main St Ste 9
Ipswich, MA 01938-2345
Phone
(978) 704-1212
Fax
(978) 338-4054
NPI assigned
Aug 11, 2020
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle C McDonald, LICSWNPI 1962841999
Title
President
Phone
(978) 704-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4 S Main St Ste 9
Ipswich, MA 01938-2345

Mailing address

4 S Main St Ste 9
Ipswich, MA 01938-2345
Phone (978) 704-1212

Other names 1

  • Corf Psychology Group LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201116002856 MA Part B Supplier - Clinic/Group Practice 7012328461 Receives reassigned benefits from 5 practitioners
Practice locations: Ipswich, MA

National Provider Directory

National Provider Directory

Locations

4 S Main St
Ste 9
Ipswich, MA 01938
Phone (978) 704-1212

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1962013235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S MAIN ST STE 9",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019382345",
            "telephone_number": "978-704-1212",
            "fax_number": "978-338-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S MAIN ST STE 9",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019382345",
            "telephone_number": "978-704-1212",
            "fax_number": "978-338-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORF PSYCHOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-704-1212",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corf Psychology Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ipswich, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.