Individual provider Active NPI

Jamie King, LICSW

  • Clinical Social Worker
  • Lawrence, MA
National Provider Identifier
1013347798
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119408 Issued in MA
Practice address
12 Methuen St
Lawrence, MA 01840-1772
Phone
(978) 587-1998
NPI assigned
Nov 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 119408 MA Primary

Addresses

Primary practice location

12 Methuen St
Lawrence, MA 01840-1772

Mailing address

21 Smith St
Haverhill, MA 01832-3729
Phone (617) 519-8364

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
I20160315002347 MA Practitioner - Clinical Social Worker 5991001026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

89 N Main St
Suite 206
Andover, MA 01810-3897
Phone (978) 409-7974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119408MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jamie L King Licsw, LLC CurrentSince Dec 15, 2024 Accepting new patients

Locations

89 N Main St
#206
Andover, MA 01810
Phone (978) 409-7974

89 N Main St
Ste 206
Andover, MA 01810
Phone (978) 409-7974

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1013347798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SMITH ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018323729",
            "telephone_number": "617-519-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 METHUEN ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401772",
            "telephone_number": "978-587-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JAMIE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.