Active NPI
Jack Harshman, LMHC
- Clinical Social Worker
- Jamaica Plain, MA
National Provider Identifier
1013133677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4338
- Practice address
- 55 Robinwood Ave
Jamaica Plain, MA 02130-2157 - Phone
- (781) 871-6550
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4338 | MA | Primary |
Addresses
Primary practice location
55 Robinwood Ave
Jamaica Plain, MA 02130-2157
Mailing address
75 Carolina Ave
Apt. #1
Jamaica Plain, MA 02130-3215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4338 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013133677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 CAROLINA AVE",
"address_2": "APT. #1",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 ROBINWOOD AVE",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021302157",
"telephone_number": "781-871-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARSHMAN",
"first_name": "JACK",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "4338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.