Jacqueline M Humphreys, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113888 Issued in MA

Practice address

110 N Hillside Rd
#29
South Deerfield, MA 01373-9726

Phone

(413) 364-3527

NPI assigned

Nov 8, 2007

Last updated

Jul 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1144400938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N HILLSIDE RD",
            "address_2": "#29",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "013739726",
            "telephone_number": "413-364-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N HILLSIDE RD",
            "address_2": "#29",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "013739726",
            "telephone_number": "413-364-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Gravino
• Melissa Lynn Greene
• Amber Celeste Hickerson, MSHS
• Renee M. Hill
• Kathryn Hoffman
• Jen Malcolm-Brown, PLLC
• Justine Karanian, D.M.D.
• Jessica King, LMHC
• John Laurence Kolodin, MSW LICSW
• Alice Kraiza

• Clinical Social Worker in South Deerfield, MA
• Providers in South Deerfield, 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 Jul 15, 2016; 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.