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Tegan Mallary Polhamus , LICSW

Social Worker β€’ Gloucester, MA

Active NPI 1063709806 Individual Practitioner Female Practitioner
Practice location in NPPES

3 Blackburn Center
Gloucester, MA 01930

Call 9782837793 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3 Blackburn Center

Gloucester, MA 01930

Telephone 9782837793

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gloucester and Massachusetts

34 active clinicians are listed under Social Worker with a practice address in Gloucester, MA (5,517 in Massachusetts).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gloucester

2.9% of these 34 clinicians have the CMS telehealth indicator.

5.9% of these 34 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

License # reported to NPPES MA 120986

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Social Worker

NUCC Taxonomy Code: 104100000X

License # reported to NPPES MA 221026

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Massachusetts Board of Registration in Medicine.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
βœ…
NPI Profile Active January 30, 2018

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location January 30, 2018

Registered at 3 BLACKBURN CENTER, GLOUCESTER, MA 01930 (Tel: 9782837793)

πŸ“
Updated Business Mailing Address January 30, 2018

Registered at 3 BLACKBURN CENTER, GLOUCESTER, MA 019305040 (Tel: 9782837793)

πŸ‘€
Provider Name / Credentials Updated January 30, 2018

Recorded as TEGAN POLHAMUS, LICSW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2018

Social Worker (license number reported to NPPES: MA 120986)

πŸ“
Updated Practice Location February 07, 2017

Registered at 33 COMMERCIAL ST, GLOUCESTER, MA 019305040 (Tel: 9782837793)

πŸ“
Updated Business Mailing Address February 07, 2017

Registered at 33 COMMERCIAL ST, GLOUCESTER, MA 019305040 (Tel: 9782837793)

πŸ‘€
Provider Name / Credentials Updated February 07, 2017

Recorded as TEGAN POLHAMUS, LCSW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2017

Social Worker (license number reported to NPPES: MA 221026)

βœ…
NPI Profile Active September 17, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 17, 2012

Registered at 63 COLLEGE AVE, SOMERVILLE, MA 021441957 (Tel: 6174406016)

πŸ“
Business Mailing Address (Initial Record) September 17, 2012

Registered at 111 SOUTH ST, SOMERVILLE, MA 021434297 (Tel: 7816862044)

πŸ‘€
Provider Name / Credentials (Initial Record) September 17, 2012

Recorded as TEGAN WALSH

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2012

Community Health Worker

🟒
Initial NPI Registration & Enumeration June 30, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1063709806
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2011
Last Update: January 30, 2018
Sole Proprietor: No

Mailing Address

3 Blackburn Center

Gloucester, MA 019305040

Phone: 9782837793

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.