MR. THOMAS FRIEDL PORTER (LICSW) – Clinical Social Worker, NPI 1770564551

MR. THOMAS FRIEDL PORTER (LICSW) is a healthcare provider. based in Southbridge, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 102096 (MA). The NPI Number for MR. THOMAS FRIEDL PORTER (LICSW) is 1770564551

Main info

Male
53 Years Of Experience
Accepts Medicare Assignment
Name
MR. THOMAS FRIEDL PORTER (LICSW)
NPI
1770564551
Phone
(508) 765-9167
Address
29 PINE STREET
Enumeration Date
9 November 2005
Last Update Date
15 June 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5087659167
Graduation Year
1973 (53 years ago)
PAC ID
3173414547
Group Practice PAC ID
4284539891
Professional Enrollment ID
I20040324000130
Address ID
MA015501823SO29XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for MR. THOMAS FRIEDL PORTER (LICSW)

  • 29, Pine Street, Southbridge, Worcester County, Massachusetts, 01550, United States

    SOUTHBRIDGE, MA 01550

    Phone: (508) 765-9167

    Fax: (508) 764-2462

    Mailing address matches the actual address.

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: 2004-03-24

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
I20040324000130IClinical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes7819$0
View full utilization report →

Insurance plans in this area (ZIP 01550)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284539891View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MA
-MA
-MA
Family PracticeMA
Physician AssistantMA
Pulmonary Disease, Critical Care (Intensivists), Allergy/ImmunologyMA
-MA
-MA
Internal MedicineMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What NPI should I save for MR. THOMAS FRIEDL PORTER (LICSW)?
Save NPI 1770564551 if you need a stable reference for MR. THOMAS FRIEDL PORTER (LICSW).
Is MR. THOMAS FRIEDL PORTER (LICSW) currently active in the NPI registry?
CMS-published data lists MR. THOMAS FRIEDL PORTER (LICSW) as an active registrant.
Does MR. THOMAS FRIEDL PORTER (LICSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for MR. THOMAS FRIEDL PORTER (LICSW). Clinical services aligned with this taxonomy classification.
Does MR. THOMAS FRIEDL PORTER (LICSW) practice in Massachusetts?
You will see Southbridge, Massachusetts on file for MR. THOMAS FRIEDL PORTER (LICSW) alongside any extra practice locations.
What if Southbridge, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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