Individual provider Active NPI

Carol Swenson Jue, LICSW

  • Clinical Social Worker
  • Keene, NH
National Provider Identifier
1629181722
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
491 Issued in NH
Practice address
64 Main St
Suite 301
Keene, NH 03431-3701
Phone
(603) 283-1504
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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 491 NH Primary

Addresses

Primary practice location

64 Main St
Suite 301
Keene, NH 03431-3701

Mailing address

23 Ridgewood Ave
Keene, NH 03431-2869
Phone (603) 283-1504

Other identifiers 1

IdentifierTypeStateIssuer
81263595MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
491NHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1629181722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 RIDGEWOOD AVE",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034312869",
            "telephone_number": "603-283-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAIN ST",
            "address_2": "SUITE 301",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313701",
            "telephone_number": "603-283-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUE",
        "first_name": "CAROL",
        "middle_name": "SWENSON",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81263595",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.