Jill McKiernan

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10667 Issued in MA

Practice address

585 Lincoln St
Worcester, MA 01605-1906

Phone

(508) 792-5400

Fax

(508) 831-0074

NPI assigned

May 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• Spectrum Health Systems, Inc

  • Community/Behavioral Health Agency
  • Worcester, MA
  • NPI 1346430253
  Medicare reassignment NPD
• Spectrum Health Systems Inc

  • Multi-Specialty Clinic/Center
  • Worcester, MA
  • NPI 1376827188
  NPD
• Spectrum Health Systems, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Worcester, MA
  • NPI 1487608485
  NPD (past)

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1184072431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MECHANIC ST",
            "address_2": "SUITE 302",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082420",
            "telephone_number": "508-792-5400",
            "fax_number": "508-831-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051906",
            "telephone_number": "508-792-5400",
            "fax_number": "508-831-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIERNAN",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer McKenzie
• Marcus McKenzie
• Maribel McKenzie, RN, BSN
• Melissa McKenzie, MA
• Edward F McKeon, LMFT
• Steven Edward McKinley, N.P.
• Catherine M McKinnon, NP
• Joseph Alexander McKinnon, D.O.
• Alice McKissick
• Demi McLaren, LICSW

• Mental Health Counselor in Worcester, MA
• Providers in Worcester, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.