Annie Clock, MSW, LICSW
Social Worker, Clinical in Boston, MA. Individual provider (NPI-1).
NPI number1902270655
StatusActive
Last updated in NPPESSep 27, 2026
Details
- NPI
- 1902270655
- Entity type
- Individual (NPI-1)
- Name
- Annie Clock
- Credential
- MSW, LICSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 18, 2015
- Certification date
- Sep 27, 2026
- Last updated
- Sep 27, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 121018 | MA | Yes |
Practice location
300 Longwood AveBoston, MA 02115-5724
Phone 617-355-6642
Mailing address
300 Longwood AveBoston, MA 02115-5724
Phone 617-355-6642
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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