Individual provider Active NPI

Jennifer Robinette Conniff, MSW, LCSW

  • Clinical Social Worker
  • Bourne, MA
National Provider Identifier
1003192097
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
219295 Issued in MA
Practice address
32 Holt Rd
Bourne, MA 02532-3434
Phone
(774) 810-0010
Fax
(508) 445-0077
NPI assigned
Oct 23, 2011
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 219295 MA Primary

Addresses

Primary practice location

32 Holt Rd
Bourne, MA 02532-3434

Mailing address

32 Holt Rd
Bourne, MA 02532-3434
Phone (774) 810-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420002022 MA Practitioner - Clinical Social Worker 2860790078 Practice locations: Buzzards Bay, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

32 Holt Rd
Buzzards Bay, MA 02532-3434
Phone (774) 810-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
219295MAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1003192097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HOLT RD",
            "city": "BOURNE",
            "state": "MA",
            "postal_code": "025323434",
            "telephone_number": "774-810-0010",
            "fax_number": "508-445-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 HOLT RD",
            "city": "BOURNE",
            "state": "MA",
            "postal_code": "025323434",
            "telephone_number": "774-810-0010",
            "fax_number": "508-445-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNIFF",
        "first_name": "JENNIFER",
        "middle_name": "ROBINETTE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-23",
        "last_updated": "2022-07-06",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "219295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourne, MA

Sources for this page

Verify at the official NPI Registry.