Jessica D Hersom, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC20114 Issued in ME

Practice address

119 Northport Ave FL 1
Belfast, ME 04915-6069

Phone

(207) 505-4567

Fax

(207) 536-2794

NPI assigned

Mar 26, 2018

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

Other names 1

• Jessica Donna Hersom Other name

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mainehealth Waldo Hospital Hospital, Belfast, ME, CCN 201312

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

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.

• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Mainehealth

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932
  Medicare reassignment NPD
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • Maternal & Fetal Medicine Physician
  • Portland, ME
  • NPI 1063726891
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mainehealth

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932
  Care Compare affiliation

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1316442940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 NORTHPORT AVE FL 1",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156069",
            "telephone_number": "207-505-4567",
            "fax_number": "207-536-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NORTHPORT AVE FL 1",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049156069",
            "telephone_number": "207-505-4567",
            "fax_number": "207-536-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSOM",
        "first_name": "JESSICA",
        "middle_name": "D",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC6782",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HERSOM",
            "middle_name": "DONNA",
            "credential": "LADC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ohla Hassan, PA-C
• Healthcare Management, Inc.
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• Randolph H Helmholz, MD
• Jodie Hermann, D.O.
• Larry J Hess, LCSW
• Heather Marie Hessler, PT
• Barbara B Heublein, MD
• Meredith L Hill, LCSW
• Donna C Hills, PT

• Clinical Social Worker in Belfast, ME
• Providers in Belfast, 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 Jan 22, 2026; 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.