Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Keith Patrick Wales, LICSW

Individual provider Clinical Social Worker · NPI 1902911191

Mr. Keith Patrick Wales, LICSW is a Clinical Social Worker in Beverly, Massachusetts. Qualified in 2004, 22 years ago. Practices with Eliot Community Human Services, a 81-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
22
Licensed in
MA
In the registry since
2006
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

800 Cummings Ctr Ste 266T
Beverly, MA 01915-6175
Phone: (978) 921-1190
Fax: (978) 927-3724
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 113671 (MA)

Record details

NPI number1902911191
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedAugust 20, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Eliot Community Human Services — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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