Active NPI
Jennifer A. Wiessner, LCSW
- Clinical Social Worker
- Cumberland, ME
National Provider Identifier
1548468978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC10403
- Practice address
- 160 Longwoods Rd
Cumberland, ME 04021-8702 - Phone
- (207) 400-7808
- NPI assigned
- Jul 6, 2007
- Last updated
- Feb 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC10403 | ME | Primary |
Addresses
Primary practice location
160 Longwoods Rd
Cumberland, ME 04021-8702
Mailing address
118 Baston Rd
North Yarmouth, ME 04097-6414
Phone (207) 829-8234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 8, 2015 through Jul 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC10403 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265068800000",
"number": "1548468978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 BASTON RD",
"city": "NORTH YARMOUTH",
"state": "ME",
"postal_code": "040976414",
"telephone_number": "207-829-8234",
"fax_number": "207-829-8234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 LONGWOODS RD",
"city": "CUMBERLAND",
"state": "ME",
"postal_code": "040218702",
"telephone_number": "207-400-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESSNER",
"first_name": "JENNIFER",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-06",
"last_updated": "2010-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC10403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumberland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.