Jacqueline C Doe, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121755 Issued in MA

Practice address

165 Main St Unit 213
Medway, MA 02053-1584

Phone

(508) 216-0331

NPI assigned

Dec 11, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15415/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 12, 2021.

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1013513209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST UNIT 213",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "508-216-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST UNIT 213",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "508-216-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOE",
        "first_name": "JACQUELINE",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Erin Dempsey
• Jennifer Lee Denaro, PSY.D.
• Desire Wellness, LLC
• Devine Healthcare Inc
• Debra Lee Dodge
• Karen Louise Doherty, OTR
• James A Doolittle, RPH
• Melanie A Duarte, LMHC
• Lynette Ann Dunn-Nastasi, LICSW
• Kylee C. Eagles, D.O.

• All providers in Medway, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.