Individual provider Active NPI

Carol A Hannon, LICSW

  • Clinical Social Worker
  • Westborough, MA
National Provider Identifier
1962606335
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1015650 Issued in MA
Practice address
21 Longmeadow Rd
Moak Associates
Westborough, MA 01581-2419
Phone
(508) 898-8650
Fax
(508) 870-9793
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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 1015650 MA Primary

Addresses

Primary practice location

21 Longmeadow Rd
Moak Associates
Westborough, MA 01581-2419

Mailing address

PO Box 260
Moak Associates
Westborough, MA 01581-0260
Phone (508) 898-8650

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Management, LLP PastSince Apr 15, 1998 Accepting new patients
Golden Insight Inc PastSince Apr 25, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1962606335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "address_2": "MOAK ASSOCIATES",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015810260",
            "telephone_number": "508-898-8650",
            "fax_number": "508-870-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LONGMEADOW RD",
            "address_2": "MOAK ASSOCIATES",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812419",
            "telephone_number": "508-898-8650",
            "fax_number": "508-870-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "CAROL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1015650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.