Jessica Plourde Wilson, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC8165 Issued in ME

Practice address

12 Bolduc Ave
Fort Kent, ME 04743-1602

Phone

(207) 834-3971

Fax

(207) 834-3837

NPI assigned

Aug 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fish River Rural HealthGroup PAC ID 3577531953, 21 clinicians

The Counseling Center of Nashua IncGroup PAC ID 3274523758, 250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.wilson.1@10077.direct.athenahealth.com

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.

• Fish River Rural Health

  • Federally Qualified Health Center (FQHC)
  • Fort Kent, ME
  • NPI 1174741094
  Medicare reassignment Care Compare group NPD
• The Counseling Center of Nashua Inc

  • Clinical Psychologist
  • Nashua, NH
  • NPI 1144275389
  Care Compare group
• Fish River Rural Health

  • Federally Qualified Health Center (FQHC)
  • Van Buren, ME
  • NPI 1528608437
  NPD
• Life by Design

  • Health Maintenance Organization
  • Caribou, ME
  • NPI 1316222037
  NPD (past)
• Life by Design, PA

  • Clinical Social Worker
  • Presque Isle, ME
  • NPI 1053345918
  NPD (past)
• Professional Home Nursing, Inc

  • Home Health Agency
  • Caribou, ME
  • NPI 1386647592
  NPD (past)
• Carlos G. Otis Health Care Center Inc.

  • Critical Access Hospital
  • Townshend, VT
  • NPI 1255337473
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1104931997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BOLDUC AVE",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431602",
            "telephone_number": "207-834-3971",
            "fax_number": "207-834-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BOLDUC AVE",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431602",
            "telephone_number": "207-834-3971",
            "fax_number": "207-834-3837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Carter St",
            "address_purpose": "LOCATION",
            "city": "Eagle Lake",
            "state": "ME",
            "postal_code": "047393060",
            "country_code": "US",
            "telephone_number": "207-444-5973",
            "fax_number": "207-444-5520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "PLOURDE",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC8165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414770099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn Amy Violette, DPT
• Amy Voisine, MHRT-C
• Walgreen Eastern Co Inc
• West Main Pharmacy Inc
• White Smiles Family Dentistry
• Matthew H. Wilson, PMH-NP
• Raymond Wong Jr., DO
• Charles P Zafonte, LADC

• Clinical Social Worker in Fort Kent, ME
• Providers in Fort Kent, 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 Mar 22, 2021; 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.