Jean F. Clarke-Mitchell, MSW, LICSW
Individual provider Active NPI Clinical Social Worker · Lee, MA
NPI 1629169883 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629169883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 112146 (MA)
- Practice address
- 30 Ferncliff Ave
Lee, MA 01238-1606 - Phone
- (413) 243-2608
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
222 S St
Suite 201
Pittsfield, MA 01201-6818
Phone (413) 218-6467
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080506000337 | MA | Practitioner - Clinical Social Worker | 2062591803 | Practice locations: Pittsfield, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurological Consultants, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 112146 | MA | Yes |
Addresses
Primary practice location
30 Ferncliff Ave
Lee, MA 01238-1606
Mailing address
30 Ferncliff Ave
Lee, MA 01238-1606
Phone (413) 243-2608
Other providers in Lee, MA
- Amy C Campion
- Rebecca Cao
- Diane Lynn Carroll
- Peter E Cerruti
- Christian Counseling and Reconciliation Inc
- Terrance Alan Clarke
- Daniel Cohen
- Collaborative Endeavors, LLC
- Claudia Ann Colombari
- Community Health Programs
All providers in Lee, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.