Individual provider Active NPI

Jordan D Henry, LCSW

  • Clinical Social Worker
  • Old Town, ME
National Provider Identifier
1487543989
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC24498 Issued in ME
Practice address
27 Pine St Apt 1
Old Town, ME 04468-1711
Phone
(207) 478-9484
NPI assigned
Jun 30, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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 LC24498 ME Primary

Addresses

Primary practice location

27 Pine St Apt 1
Old Town, ME 04468-1711

Mailing address

27 Pine St Apt 1
Old Town, ME 04468-1711
Phone (207) 478-9484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20251010001613 ME Practitioner - Clinical Social Worker 8820595127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

27 Pine St
Apt 1
Old Town, ME 04468-1711

50 Moody St
Saco, ME 04072-0892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC24498MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Sep 19, 2025 Accepting new patients

Locations

28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

Organizations & group practices 1

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1487543989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 PINE ST APT 1",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681711",
            "telephone_number": "207-478-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 PINE ST APT 1",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681711",
            "telephone_number": "207-478-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JORDAN",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC24498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Town, ME

Sources for this page

Verify at the official NPI Registry.