Individual provider Active NPI

Alexandria Santiago, LICSW

  • Clinical Social Worker
  • Winthrop, MA
National Provider Identifier
1992106165
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
124982 Issued in MA
Practice address
102 Pleasant St Apt 2
Winthrop, MA 02152-2021
Phone
(781) 562-9159
NPI assigned
Sep 8, 2014
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 223005 MA
Clinical Social Worker 1041C0700X 124982 MA Primary

Addresses

Primary practice location

102 Pleasant St Apt 2
Winthrop, MA 02152-2021

Mailing address

102 Pleasant St Apt 2
Winthrop, MA 02152-2021
Phone (781) 562-9159

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
I20221012001887 MA Practitioner - Clinical Social Worker 8022484393 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124982MAMDClinical Social Worker
223005MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alle Santiago LLC Clinical CurrentSince Aug 18, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1992106165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PLEASANT ST APT 2",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021522021",
            "telephone_number": "781-562-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PLEASANT ST APT 2",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021522021",
            "telephone_number": "781-562-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ALEXANDRIA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "223005",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winthrop, MA

Sources for this page

Verify at the official NPI Registry.