ELIZABETH TALEAS SOUTHALL (LICSW) – Social Worker, NPI 1225211436

ELIZABETH TALEAS SOUTHALL (LICSW) is a healthcare provider. based in Hanover, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 212052 (MA). The NPI Number for ELIZABETH TALEAS SOUTHALL (LICSW) is 1225211436

Main info

Female
24 Years Of Experience
Name
ELIZABETH TALEAS SOUTHALL (LICSW)
NPI
1225211436
Phone
(617) 552-5124
Address
427 COLUMBIA RD
Enumeration Date
11 December 2007
Last Update Date
19 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7183120056
Graduation Year
2002 (24 years ago)
PAC ID
8729370259
Professional Enrollment ID
I20160701001215
Address ID
MA023392369HA720XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for ELIZABETH TALEAS SOUTHALL (LICSW)

  • 427, Columbia Road, Hanover, Plymouth County, Massachusetts, 02359, United States

    HANOVER, MA 023393213

    Phone: (617) 552-5124

    Type: Location

  • PO BOX 934

    HANOVER, MA 023390934

    Phone: (617) 552-5124

    Fax: (888) 317-2641

    Type: Mailing

  • 720 WASHINGTON ST STE 603

    HANOVER, MA 023392476

    Phone: (617) 306-2748

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160701001215IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02339)

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Reviews

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Frequently asked questions

What unique ID ties claims to ELIZABETH TALEAS SOUTHALL (LICSW)?
NPI 1225211436 is assigned to ELIZABETH TALEAS SOUTHALL (LICSW) under the national enumeration system.
Is ELIZABETH TALEAS SOUTHALL (LICSW) currently active in the NPI registry?
CMS-published data lists ELIZABETH TALEAS SOUTHALL (LICSW) as an active registrant.
Does ELIZABETH TALEAS SOUTHALL (LICSW) list a primary specialty?
If you are matching referrals, note Social Worker for ELIZABETH TALEAS SOUTHALL (LICSW). Clinical services aligned with this taxonomy classification.
Does ELIZABETH TALEAS SOUTHALL (LICSW) practice in Massachusetts?
You will see Hanover, Massachusetts on file for ELIZABETH TALEAS SOUTHALL (LICSW) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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