NPIMap

Individual provider Active NPI

Olivia Jenkins

  • Developmental Therapist
  • Milford, MA
National Provider Identifier
1073252763
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
300 E Main St
Milford, MA 01757
Phone
(774) 462-8393
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary
Social Worker 104100000X
Case Manager/Care Coordinator 171M00000X
Community Health Worker 172V00000X

Addresses

Primary practice location

300 E Main St
Milford, MA 01757

Mailing address

20 Fleetwood Dr
Norfolk, MA 02056-1028
Phone (508) 561-9190

Other practice location 1

345 Old Plymouth Rd
Sagamore Beach, MA 02562-2304
Phone (508) 561-9190

Other practice location 2

1370 S West Temple
Salt Lake City, UT 84115-5218
Phone (801) 678-3317

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Anthony House Treatment Programs Past Accepting new patients
Sagamore Counseling PastSince Oct 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1073252763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FLEETWOOD DR",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "020561028",
            "telephone_number": "508-561-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "01757",
            "telephone_number": "774-462-8393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Old Plymouth Rd",
            "address_purpose": "LOCATION",
            "city": "Sagamore Beach",
            "state": "MA",
            "postal_code": "025622304",
            "country_code": "US",
            "telephone_number": "508-561-9190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1370 S West Temple",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841155218",
            "country_code": "US",
            "telephone_number": "801-678-3317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.