Jessica Haley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC10404 Issued in ME

Practice address

3388 Aroostook Road
Eagle Lake, ME 04739

Phone

(207) 492-1036

Fax

(207) 492-1830

NPI assigned

Sep 13, 2007

Last updated

Sep 13, 2007By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1073708947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 BOONE RD",
            "city": "MAPLETON",
            "state": "ME",
            "postal_code": "047574320",
            "telephone_number": "207-764-1035",
            "fax_number": "207-432-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3388 AROOSTOOK ROAD",
            "city": "EAGLE LAKE",
            "state": "ME",
            "postal_code": "04739",
            "telephone_number": "207-492-1036",
            "fax_number": "207-492-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC10404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24884099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Dubay
• Edgewell
• Fish River Rural Health
• Fish River Rural Health
• Dawn Gagnon, RN
• Kyla Lee Jonah-Hourihan, PT
• Darla Jean Nesbitt, RN
• Northern Maine General
• Northern Maine General (Mercy Home)
• Northern Maine General (Marcoux Waiver Home)

• Clinical Social Worker in Eagle Lake, ME
• Providers in Eagle Lake, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.

Verify at the official NPI Registry.