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

Individual provider Mental Health Counselor · NPI 1770564551

Mr. Thomas Friedl Porter, LICSW is a Clinical Social Worker in Southbridge, Massachusetts. Qualified in 1973, 53 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
53
Licensed in
MA
In the registry since
2005
Specialties on file
2
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

29 Pine St
Southbridge, MA 01550
Phone: (508) 765-9167
Fax: (508) 764-2462
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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 102096 (MA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 102096 (MA)

Record details

NPI number1770564551
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedNovember 9, 2005
Last updated in NPPESJune 15, 2011

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1973 (53 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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