Jeannie Giberson, LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC3054 Issued in ME

Legal business name

JEANNIE GIBERSON, LCSW LLC

Practice address

200 High St
Portland, ME 04101-2831

Phone

(207) 772-0779

NPI assigned

Aug 11, 2016

Organization subpart

No

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

Authorized official

Name

Jeannie Elizabeth Giberson, LCSWNPI 1780722256

Title

Sole Member

Phone

(207) 772-0779

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeannie Elizabeth Giberson, LCSW

  • Clinical Social Worker
  • Portland, ME
  • NPI 1780722256
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1326592940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012831",
            "telephone_number": "207-772-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012831",
            "telephone_number": "207-772-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNIE GIBERSON, LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "GIBERSON",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "207-772-0779",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC3054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliet Jarrell, MD
• Matthew Jarvis
• Rebecca Jaynes, LCPC
• William Dean Jeanblanc, MD
• Jeanne McKew
• Jeffery S. Clark, D.C., P.a.
• Kateri Jeffery, FNP-BC
• Jeffrey P York, MD
• Dayla Jeney
• Natalya Anne Jenney, OTD, OTR/L

• 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 Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.