Susan L. Jimerson, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

114821 Issued in MA

Practice address

50 Long Pond Dr
South Yarmouth, MA 02664-4180

Phone

(508) 760-1475

NPI assigned

Jun 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Duffy Health Center, IncGroup PAC ID 1951211598, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Duffy Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Hyannis, MA
  • NPI 1588616742
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1093001570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LONG POND DR",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026644180",
            "telephone_number": "508-760-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LONG POND DR",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026644180",
            "telephone_number": "508-760-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMERSON",
        "first_name": "SUSAN",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "114821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrey Houle
• Amanda Louise Jablonski
• Bonnie Jean Jackson, PT
• Jefferson S Dexter DMD PC
• Deanna Jennings
• Andrew Craig Johnson
• Stephenq Micheal Jordan, M.S.
• Mari Judge
• Arthur George Kalil Jr., DPM
• Karen Desimone, LLC

• Mental Health Counselor in South Yarmouth, MA
• Providers in South Yarmouth, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.