Individual provider Active NPI

Jessica Amber Barke, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1164850012
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116130 Issued in MA
Practice address
22 Hilliard St
Marci Rd Nutrition
Cambridge, MA 02138-4972
Phone
(617) 335-5855
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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 116130 MA Primary

Addresses

Primary practice location

22 Hilliard St
Marci Rd Nutrition
Cambridge, MA 02138-4972

Mailing address

22 Hilliard St
Marci Rd Nutrition
Cambridge, MA 02138-4972
Phone (617) 335-5855

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
116130MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1164850012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HILLIARD ST",
            "address_2": "MARCI RD NUTRITION",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384972",
            "telephone_number": "617-335-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HILLIARD ST",
            "address_2": "MARCI RD NUTRITION",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384972",
            "telephone_number": "617-335-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKE",
        "first_name": "JESSICA AMBER",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.