Individual provider Active NPI

Nancy Harris Jaeger, LCSW

  • Clinical Social Worker
  • Bath, ME
National Provider Identifier
1467630509
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC1379 Issued in ME
Practice address
141 Front St
Bath, ME 04530
Phone
(207) 443-6950
NPI assigned
Jan 31, 2008
Last updated
Jan 31, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC1379 ME Primary

Addresses

Primary practice location

141 Front St
Bath, ME 04530

Mailing address

141 Front St
Bath, ME 04530
Phone (207) 443-6950

Other identifiers 2

IdentifierTypeStateIssuer
11540518OtherMECAQH
099073OtherMEBCBS

Other names 1

  • Nancy Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC1379MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1467630509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 FRONT ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "04530",
            "telephone_number": "207-443-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 FRONT ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "04530",
            "telephone_number": "207-443-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "NANCY",
        "middle_name": "HARRIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC1379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11540518",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "099073",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "HARRIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bath, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.