Individual provider Active NPI

Jessica Erin Stephenson, LCSW-C

  • Clinical Social Worker
  • Salisbury, MD
National Provider Identifier
1558042507
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26032 Issued in MD
Practice address
1104 Healthway Dr
Salisbury, MD 21804-4469
Phone
(410) 219-5483
Fax
(410) 219-5486
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 26032 MD Primary

Addresses

Primary practice location

1104 Healthway Dr
Salisbury, MD 21804-4469

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

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
I20231014000470 MD Practitioner - Clinical Social Worker 6800241605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Lower Counties Community Services IncGroup PAC ID 3678484300, 74 clinicians

Practice addresses (Care Compare)

32033 Beaver Run Dr
Salisbury, MD 21804-1773
Phone (410) 749-1015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services Inc Current Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Aug 18, 2023 Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Nov 13, 2023 Accepting new patients

Locations

1910 Towne Centre Blvd
Ste 250
Annapolis, MD 21401
Phone (202) 596-8891

9958 N Main St
Unit 2
Berlin, MD 21811

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

1104 Healthway Dr
Salisbury, MD 21804
Phone (410) 219-1100

Organizations & group practices 4

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1558042507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 HEALTHWAY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044469",
            "telephone_number": "410-219-5483",
            "fax_number": "410-219-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "JESSICA",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "26032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.