Jennifer Michelle Marram Bognanno, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

216599 Issued in MA

Practice address

215 Main St Ste 210
Brockton, MA 02301-4328

Phone

(508) 897-8000

NPI assigned

Feb 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1073819082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020720207",
            "telephone_number": "781-801-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MAIN ST STE 210",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014328",
            "telephone_number": "508-897-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGNANNO",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE MARRAM",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "216599",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "216599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF MASSACHUSETTS",
            "identifier": "117526",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Srinivas Bodapati, MD
• Lynne D Boddie
• Body Healing Therapeutic Inc
• Daniel John Boen
• Carolyn B Bogal, NP
• Daniel Leroy Bohl, MD
• Catherine Brooke Bohnsack, MA
• Romie Bois
• Christine Boisvert, LCSW
• Amy Karen Bolinder, LICSW

• Clinical Social Worker in Brockton, MA
• Providers in Brockton, 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 Apr 9, 2018; 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.