Jennifer W. Goodwin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC1825 Issued in ME

Practice address

55 Bell St
Portland, ME 04103-3418

Phone

(207) 205-5741

Fax

(207) 514-8333

NPI assigned

Aug 12, 2006

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

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1245242965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 GRANITE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022844",
            "telephone_number": "207-205-5741",
            "fax_number": "207-514-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033418",
            "telephone_number": "207-205-5741",
            "fax_number": "207-514-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JENNIFER",
        "middle_name": "W.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC1825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309510099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Goodrich, MD
• Mallory Michelle Goodrich, DPT
• Ashley Marie Goodspeed
• Goodwill Industries of Northern New England
• Goodwill Industries of Northern New England
• Bernard J. Gordon, MD
• Carrie A Gordon, MD
• Donna Gordon, ANP / FNP
• George David Gordon, DMD
• Kristyn Kacie Gordon, DMD

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.