Individual provider Active NPI

Jessica Lynne Kirschensteiner, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1497163786
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24227 Issued in MD
Practice address
1111 N Charles St
Baltimore, MD 21201-5505
Phone
(410) 837-2050
Fax
(410) 837-7793
NPI assigned
Jul 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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 24227 MD Primary

Addresses

Primary practice location

1111 N Charles St
Baltimore, MD 21201-5505

Mailing address

1111 N Charles St
Baltimore, MD 21201-5505
Phone (410) 837-2050

Other identifiers 1

IdentifierTypeStateIssuer
24227OtherMDLCSW-C

Other names 1

  • Jessica Tillett Massey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20181018000375 MD Practitioner - Clinical Social Worker 0749532810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1311 S Main St
Suite 202
Mount Airy, MD 21771-5457
Phone (301) 829-2242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24227MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC CurrentSince Mar 13, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Clinical CurrentSince Mar 13, 2024 Accepting new patients

Locations

1311 S Main St
Ste 202
Mount Airy, MD 21771
Phone (301) 829-2242

650 Ritchie Hwy
Ste 207
Severna Park, MD 21146
Phone (410) 315-9350

1380 Progress Way
Ste 101
Sykesville, MD 21784
Phone (410) 549-5181

Organizations & group practices 2

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": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1497163786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-837-2050",
            "fax_number": "410-837-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-837-2050",
            "fax_number": "410-837-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHENSTEINER",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "24227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-C",
            "identifier": "24227",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MASSEY",
            "middle_name": "TILLETT",
            "credential": "LCSW, LCAS, LCSW-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.