Judith Jacques, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16112 Issued in FL

Practice address

22904 Lyden Dr Ste 104
Estero, FL 33928-7047

Phone

(239) 494-3951

Fax

(239) 217-9561

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fort Myers Psychology PAGroup PAC ID 6204936305, 9 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fort Myers Psychology, PA

  • Clinical Psychologist
  • Fort Myers, FL
  • NPI 1003028119
  Medicare reassignment Care Compare group NPD
• Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
  • NPI 1053970194
  NPD
• Psychological & Counseling Associates of the Lowcountry, LLC

  • Clinical Psychologist
  • Bluffton, SC
  • NPI 1174702096
  NPD (past)
• Psychological and Counseling Center

  • Adult Health Nurse Practitioner
  • Bluffton, SC
  • NPI 1437697224
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1407894017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N COURT ST",
            "address_2": "#1131",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575110",
            "telephone_number": "843-304-6400",
            "fax_number": "843-606-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22904 LYDEN DR STE 104",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339287047",
            "telephone_number": "239-494-3951",
            "fax_number": "239-217-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "9952",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113570",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Winfield Innis, MD
• Cesily Insana
• Integrative Rehab Medicine, Inc
• J Cole Nutrition LLC
• Nils-Otto Jaasko, PT, DPT, ATC
• Delane Johnson, LCSW
• Ruxandra Maria Johnson, BSN, RN, IBCLC
• Kristine Jukes, P.T.
• Michelle D Justice, MSN, FNP-C,PMHNP-BC
• Santosh Kagathur, M.D.

• Clinical Social Worker in Estero, FL
• Providers in Estero, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.