Jessica M Pinkham, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1402 Issued in NH

Practice address

323 Gonic Rd Ste 2a
Rochester, NH 03839-5689

Phone

(603) 332-8000

Fax

(603) 601-4476

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jessica M Miner Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 17, 2024 through Jan 17, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662854400000",
    "number": "1013128180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 GONIC RD STE 2A",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038395689",
            "telephone_number": "603-332-8000",
            "fax_number": "603-601-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 GONIC RD STE 2A",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038395689",
            "telephone_number": "603-332-8000",
            "fax_number": "603-601-4476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Mary E Clark Dr Ste 6",
            "address_purpose": "LOCATION",
            "city": "Hampstead",
            "state": "NH",
            "postal_code": "038412288",
            "country_code": "US",
            "telephone_number": "603-332-8000 x51",
            "fax_number": "603-601-4476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINKHAM",
        "first_name": "JESSICA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2022-09-11",
        "certification_date": "2022-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3101188",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077091",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30931444",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpinkham@lifebalancecoachnh.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "any",
            "address_1": "323 Gonic Rd Ste 2A",
            "city": "Rochester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "038395689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MINER",
            "middle_name": "M",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Thomas Petersen, DC
• Ryan Aaron Pham
• Caitlin Phelps Jessel, PA-C
• Allison Picone
• Ericka Pine, RD, LD
• Michael Piotrowski
• Jaclyn Plante
• Catherine Plasse, LICSW, MLADC, CCTP
• Cynthia J Porter, PT
• Danielle Prevost

• Clinical Social Worker in Rochester, NH
• Providers in Rochester, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.