Jessica Mkpanam, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

127977 Issued in MA

Practice address

21 Father Devalles Blvd Ste 15
Fall River, MA 02723-1519

Phone

(978) 408-6446

Fax

(508) 567-3309

NPI assigned

Jan 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Fitzgerald Counseling Group

  • Mental Health Counselor
  • Fall River, MA
  • NPI 1093297616
  NPD

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1316484298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 PLEASANT ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FATHER DEVALLES BLVD STE 15",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027231519",
            "telephone_number": "978-408-6446",
            "fax_number": "508-567-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MKPANAM",
        "first_name": "JESSICA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian J Mitchell, LICSW
• Chryssa Marie Mitchell
• Grace M. Mitchell
• John R Mitchell, LICSW
• Susan Anne Mitchell, LICSW
• Mikyong Mobilia, CPNP-PC
• Modern Dermatology of Massachusetts, PLLC
• Elisabeth Karen Modestino, LICSW
• Elizabeth Modiclan
• Carla Moe, LICSW

• Clinical Social Worker in Fall River, MA
• Providers in Fall River, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.