Elaine A Wasserman, MSW LICSW ACSW MAC C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

103949 Issued in MA

Practice address

686 N Main St
Brockton, MA 02301

Phone

(508) 587-0815

Fax

(508) 586-9446

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Old Colony Young Mens Christian Association IncGroup PAC ID 7416991393, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Old Colony Young Men'S Christian Association, Inc.

  • Clinical Psychologist
  • Brockton, MA
  • NPI 1366506677
  Medicare reassignment Care Compare group NPD
• Gosnold, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Falmouth, MA
  • NPI 1639219314
  Medicare reassignment
• Catholic Charitable Bureau of the Archdiocese of Boston, Inc.

  • Community/Behavioral Health Agency
  • South Boston, MA
  • NPI 1003979014
  NPD (past)
• Catholic Charitable Bureau of the Archdiocesse of Boston, Inc. Dba

  • Home Health Agency
  • South Boston, MA
  • NPI 1093723652
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972682185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 N MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-587-0815",
            "fax_number": "508-580-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 N MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-587-0815",
            "fax_number": "508-586-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "ELAINE",
        "middle_name": "A",
        "credential": "MSW LICSW ACSW MAC C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MA",
            "license": "103949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Lynn Warren
• Lesli Ellen Warren, CNM
• Shannon Lee Washburn, CASE MANAGEMENT
• John Kyle Washington, TM
• Courtney Reid Wass-Martineau, MS PT
• Matthew Waters
• Tori Waters, MD
• James Frease Watkins, MD, FACS
• Katherine Watson, CNP
• Lori Aileen Watson

• Professional Counselor in Brockton, MA
• Providers in Brockton, MA by specialty
• Professional Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.