Individual provider Active NPI

Martha Queenin, LICSW

  • School Social Worker
  • Lexington, MA
National Provider Identifier
1992288369
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
1016249-SW-LICSW Issued in MA
Practice address
251 Waltham St
Lexington, MA 02421-4903
Phone
(781) 861-2320
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 1016249-SW-LICSW MA Primary

Addresses

Primary practice location

251 Waltham St
Lexington, MA 02421-4903

Mailing address

251 Waltham St
Lexington, MA 02421-4903
Phone (781) 861-2320

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1016249-SW-LICSWMAMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1992288369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 WALTHAM ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214903",
            "telephone_number": "781-861-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 WALTHAM ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214903",
            "telephone_number": "781-861-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEENIN",
        "first_name": "MARTHA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MA",
            "license": "1016249-SW-LICSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.