RAQUEL MELYSSA PROVDA LICSW
NPI 1174888911
Social Worker - Clinical in Burlington, MA

Q: What is Raquel Provda's NPI number?

The NPI number for Raquel Provda is 1174888911. It was assigned to this individual provider in the NPPES registry on July 9, 2012.

Q: What is Raquel Provda's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Raquel Provda was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 09, 2012PECOS EnrolledAccepts Medicare Assignment

41 MALL RD, BURLINGTON, MA 01805(781) 744-8000 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 2, 2025, Dec 4, 2024, Apr 14, 2023 (3 updates tracked since 2023).

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About Raquel Melyssa Provda Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAQUEL MELYSSA PROVDA LICSW (NPI 1174888911) is an individual clinical provider in Burlington, Massachusetts, licensed in Massachusetts (LICSW1120818) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1174888911

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameRAQUEL MELYSSA PROVDACredential: LICSW

Location Address41 MALL RDBurlington, MA 01805-0001

Mailing Address11 Circle AveLynn, MA 01905-3050 · (781) 595-2413

Phone(781) 744-8000

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateJuly 9, 2012

Last NPPES UpdateDecember 2, 20253 updates tracked since enumeration

NPPES CertifiedDecember 2, 2025

✔ NPI 1174888911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MA · LICSW1120818

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

41 MALL RD, Burlington, MA 01805

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Raquel Melyssa Provda Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931691706

PECOS Enrollment IDI20251120000483

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $63.72 – $189.86

Typical copayment $0.00 (range $15.93 – $47.46)

Most-billed visit code NA

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAHOOR KHAN

Internal Medicine (Interventional Cardiology)