Individual provider Active NPI

Vannary Jarman, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1407097157
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117668 Issued in MA
Practice address
19 Tacoma St
Worcester, MA 01605-3516
Phone
(508) 595-0750
NPI assigned
Mar 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 215364 MA
Clinical Social Worker 1041C0700X CSW01222 RI
Clinical Social Worker 1041C0700X 117668 MA Primary

Addresses

Primary practice location

19 Tacoma St
Worcester, MA 01605-3516

Mailing address

153 Main St
Douglas, MA 01516-2454
Phone (401) 263-7202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20160203000951 MA Practitioner - Clinical Social Worker 2961706445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Birmingham Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward M Kennedy Community Health Center IncGroup PAC ID 3476512740, 65 clinicians

Practice addresses (Care Compare)

605 Lincoln St
Worcester, MA 01605-1901
Phone (800) 853-2288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117668MAMDClinical Social Worker
CSW01222RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Dec 28, 2015 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Dec 28, 2015 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients

Locations

41 Cape Rd
Milford, MA 01757
Phone (508) 270-5750

605 Lincoln St
Worcester, MA 01605
Phone (508) 856-0104

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1407097157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 MAIN ST",
            "city": "DOUGLAS",
            "state": "MA",
            "postal_code": "015162454",
            "telephone_number": "401-263-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-595-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARMAN",
        "first_name": "VANNARY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "215364",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01222",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.