Jacqueline Maher, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123918 Issued in MA

Practice address

45 Dimock St
Roxbury, MA 02119-1208

Phone

(617) 442-8800

Fax

(617) 541-8472

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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 and National Provider Directory roles.

• Dimock Community Services Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roxbury, MA
  • NPI 1326193269
  Medicare reassignment NPD
• Dimock Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Roxbury, MA
  • NPI 1588719488
  NPD

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1518340785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 TYLER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800",
            "fax_number": "617-541-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "JACQUELINE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110076992A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Ly
• Aisling Marie Lydeard, NP
• Caitrin Fay Macdonald, NP
• Tawana Rosita Mack
• Michelle Laura Maddex, LICSW
• Leah Elaine Mais
• Mary Rose Maiullari, PHARMD
• Patriciah K. Makora, MA
• Nelson Maldonado
• Nadia Mancia

• Clinical Social Worker in Roxbury, MA
• Providers in Roxbury, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.