Individual provider Active NPI

Jenine Marice Vindice, L.I.C.S.W.

  • Clinical Social Worker
  • Wilmington, MA
National Provider Identifier
1124162573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110281 Issued in MA
Practice address
11 Chapman Ave
Wilmington, MA 01887-1405
Phone
(617) 304-3548
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110281 MA Primary

Addresses

Primary practice location

11 Chapman Ave
Wilmington, MA 01887-1405

Mailing address

11 Chapman Ave
Wilmington, MA 01887-1405
Phone (617) 304-3548

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124162573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHAPMAN AVE",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871405",
            "telephone_number": "617-304-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHAPMAN AVE",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871405",
            "telephone_number": "617-304-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINDICE",
        "first_name": "JENINE",
        "middle_name": "MARICE",
        "name_prefix": "Mrs.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.