Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Raquel Melyssa Provda, LICSW

Individual provider Clinical Social Worker · NPI 1174888911

Raquel Melyssa Provda, LICSW is a Clinical Social Worker in Burlington, Massachusetts. Qualified in 2022, 4 years ago. Practices with Lahey Clinic Inc, a 1,372-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
4
Licensed in
MA
In the registry since
2012
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

41 Mall Rd
Burlington, MA 01805-0001
Phone: (781) 744-8000
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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 LICSW1120818 (MA)

Record details

NPI number1174888911
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJuly 9, 2012
Last updated in NPPESDecember 2, 2025
Certification dateDecember 2, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Lahey Clinic Inc — 1372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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