Active NPI
Sandra L Wolosenko, L.I.C.S.W
- Social Worker
- Medford, MA
National Provider Identifier
1982710448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 101971
- Practice address
- 151 Mystic Ave
Medford, MA 02155-4632 - Phone
- (781) 396-1199
- Fax
- (781) 396-1439
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 101971 | MA | Primary |
Addresses
Primary practice location
151 Mystic Ave
Medford, MA 02155-4632
Mailing address
156 Oak St
Florence, MA 01062-1329
Phone (413) 586-9461
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101971 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1982710448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 OAK ST",
"city": "FLORENCE",
"state": "MA",
"postal_code": "010621329",
"telephone_number": "413-586-9461",
"fax_number": "413-584-8671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 MYSTIC AVE",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021554632",
"telephone_number": "781-396-1199",
"fax_number": "781-396-1439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLOSENKO",
"first_name": "SANDRA",
"middle_name": "L",
"credential": "L.I.C.S.W",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "101971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.