Active NPI
Bethany Ann Edwards, LCSW
- Clinical Social Worker
- Milton, MA
National Provider Identifier
1992302269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 221666
- Practice address
- 34 Laurel Rd # 1
Milton, MA 02186-1522 - Phone
- (617) 943-3813
- NPI assigned
- Oct 8, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 221666 | MA | Primary |
Addresses
Primary practice location
34 Laurel Rd # 1
Milton, MA 02186-1522
Mailing address
34 Laurel Rd # 1
Milton, MA 02186-1522
Phone (617) 943-3813
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221666 | Medicaid | MA | |
| 221666 | Other | MA | BOARD OF SOCIAL WORK |
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 |
|---|---|---|---|
| 221666 | MA | MD | Clinical Social Worker |
Interoperability endpoints
- bethany.edwards.1@8526.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1992302269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 LAUREL RD # 1",
"city": "MILTON",
"state": "MA",
"postal_code": "021861522",
"telephone_number": "617-943-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 LAUREL RD # 1",
"city": "MILTON",
"state": "MA",
"postal_code": "021861522",
"telephone_number": "617-943-3813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "BETHANY",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "221666",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "221666",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF SOCIAL WORK",
"identifier": "221666",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.