Individual provider Active NPI

Jenna Driscoll, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1225879869
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC21908 Issued in ME
Practice address
175 Fore River Pkwy
Portland, ME 04102-2779
Phone
(207) 879-3526
Fax
(207) 879-3270
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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 LC21908 ME Primary

Addresses

Primary practice location

175 Fore River Pkwy
Portland, ME 04102-2779

Mailing address

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20240705000860 ME Practitioner - Clinical Social Worker 2961946629 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC21908MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Driscoll Therapy, LLC Clinical CurrentSince Feb 4, 2026 Accepting new patients
Mercy Hospital CurrentSince Jun 10, 2024 Accepting new patients
Mercy Hospital CurrentSince Jun 10, 2024 Accepting new patients

Locations

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

195 Fore River Pkwy
Ste 160
Portland, ME 04102
Phone (207) 553-6700

175 Fore River Pkwy
Portland, ME 04102
Phone (207) 553-6105

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1225879869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FORE RIVER PKWY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022779",
            "telephone_number": "207-879-3526",
            "fax_number": "207-879-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FORE RIVER PKWY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022779",
            "telephone_number": "207-879-3526",
            "fax_number": "207-879-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "JENNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.