Jessica Baine

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10487 Issued in CT

Practice address

54 North St
Willimantic, CT 06226-2528

Phone

(860) 450-7122

NPI assigned

Sep 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Change Counseling, LLC

  • Clinical Social Worker
  • Willimantic, CT
  • NPI 1780141465

  Clinical, CT

  Medicare reassignment NPD
• Nafi Connecticut Inc.

  • Clinic/Center
  • Hartford, CT
  • NPI 1619258449
  NPD (past)

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1164890232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 NORTH ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262528",
            "telephone_number": "860-450-7122",
            "fax_number": "860-450-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 NORTH ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262528",
            "telephone_number": "860-450-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.010487",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naida E. Arcenas, APRN
• Raelene Asselin
• Emmanuel Augustin
• Huseyin Nail Aydin, MD
• Jeniffer Louise Baer, DMD
• Katherine Marie Baird, PAC
• Alayna M Baker
• Carlita R Baldwin, PH.D.
• Erin Curry Bane, DNP CNM
• Kassandrah Daniella Banks, LMSW

• All providers in Willimantic, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.