Jennifer Linn Desouza, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110660 Issued in MA

Practice address

259 Massachusetts Ave
Arlington, MA 02474-8406

Phone

(617) 575-9438

NPI assigned

Dec 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Linn Mank Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 25, 2024 through Mar 25, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• South Shore Mental Health

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1881769024
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1063578482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024748406",
            "telephone_number": "617-955-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024748406",
            "telephone_number": "617-575-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOUZA",
        "first_name": "JENNIFER",
        "middle_name": "LINN",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MANK",
            "middle_name": "LINN",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dental Pro LLC
• Thomas Arthus Denton, LICSW
• Joan Minot Deppe, PSY.D.
• Cassandra Dequevedo, LMHC
• Katelynn Desimone, PHARM.D.
• Lisa Desrosiers, LAC
• Amy Lynn Destefanis, LCSW, CCM
• Ulrike Dettling, M.A., L.M.F.T.
• Stephen Grant Detucci, LMHC, LADC
• Charles J Deveikas Jr., OTR/L, CHT

• Clinical Social Worker in Arlington, MA
• Providers in Arlington, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.