Jennifer J Madore, LCSW
Individual provider Active NPI Clinical Social Worker · Limington, ME
NPI 1306173182 · NPPES record last updated Dec 19, 2023
Key facts
- NPI
- 1306173182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LC17855 (ME)
- Practice address
- 233 Jo Joy Rd
Limington, ME 04049 - Phone
- (207) 579-1417
- NPI assigned
- Nov 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190718001972 | ME | Practitioner - Clinical Social Worker | 4981939543 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LS10156 | ME | MD | Social Worker |
| LC17855 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alternative Wellness Services | Current |
Accepting new patients | |
| Primecare Physician Associates | Past | Accepting new patients |
Locations
419 Alfred St
Biddeford, ME 04005
Phone (207) 282-9080
411 Alfred St
Biddeford, ME 04005
Phone (207) 284-4586
281 Main St
Biddeford, ME 04005
Phone (207) 282-6620
525 Forest Ave
Portland, ME 04101
Phone (207) 415-8654
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LS10156 | ME | |
| Clinical Social Worker | 1041C0700X | LC17855 | ME | Yes |
Addresses
Primary practice location
233 Jo Joy Rd
Limington, ME 04049
Mailing address
233 Jo Joy Rd
Limington, ME 04049
Phone (207) 579-1417
Other providers in Limington, ME
- Barbara J Chase
- Mary Lynn Douyard
- Brenda Lee Surabian Emerson
- Pauline Hill
- Robin E.D. Illian
- Stephanie Lynne Neptune
- Paul Townsend
- Grace Merrifield Pease
- Debra Elizabeth Penney
- Pequawket Physical Therapy, LLC
All providers in Limington, ME · Clinical Social Worker in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.