Individual provider Active NPI

Jennifer Gardner, LICSW

  • Clinical Social Worker
  • Reading, MA
National Provider Identifier
1144274978
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1030466 Issued in MA
Practice address
22 Woburn St
Suite 36
Reading, MA 01867-3026
Phone
(781) 944-7700
Fax
(781) 944-7711
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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 1030466 MA Primary

Addresses

Primary practice location

22 Woburn St
Suite 36
Reading, MA 01867-3026

Mailing address

22 Woburn St
Suite 36
Reading, MA 01867-3026
Phone (781) 944-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2018 through Jan 1, 2028

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1144274978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WOBURN ST",
            "address_2": "SUITE 36",
            "city": "READING",
            "state": "MA",
            "postal_code": "018673026",
            "telephone_number": "781-944-7700",
            "fax_number": "781-944-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WOBURN ST",
            "address_2": "SUITE 36",
            "city": "READING",
            "state": "MA",
            "postal_code": "018673026",
            "telephone_number": "781-944-7700",
            "fax_number": "781-944-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JENNIFER",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1030466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, MA

Sources for this page

Verify at the official NPI Registry.