Individual provider Active NPI

Paul Viscione Jr.

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1992364830
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
124350 Issued in NY
Practice address
22 Old Canal Dr
Lowell, MA 01851-2730
Phone
(978) 453-6800
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 124350 NY Primary

Addresses

Primary practice location

22 Old Canal Dr
Lowell, MA 01851-2730

Mailing address

5 Woods Pond Dr
Westford, MA 01886-1267

Other practice location 1

11 River St
Wellesley, MA 02481-2017
Phone (781) 431-1177

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
I20211112001719 MA Practitioner - Clinical Social Worker 5597154500 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124350NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
SB Transitional Sub, LLC CurrentSince Nov 3, 2021 Accepting new patients
South Bay Mental Health Center, Inc. PastSince Sep 27, 2019 Accepting new patients
Habit Opco, LLC PastSince Nov 3, 2021 Accepting new patients

Locations

103 Commercial St
Ste 2
Brockton, MA 02302

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1992364830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WOODS POND DR",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018861267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD CANAL DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512730",
            "telephone_number": "978-453-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 River St",
            "address_purpose": "LOCATION",
            "city": "Wellesley",
            "state": "MA",
            "postal_code": "024812017",
            "country_code": "US",
            "telephone_number": "781-431-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISCIONE",
        "first_name": "PAUL",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "124350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.