Individual provider Active NPI

Jessie Kimelman Macinnes, LCSW

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1629790928
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW2120852 Issued in MA
Practice address
40 Church St
Lowell, MA 01852-6113
Phone
(508) 451-7329
NPI assigned
Sep 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LCSW2120852 MA Primary

Addresses

Primary practice location

40 Church St
Lowell, MA 01852-6113

Mailing address

4 Kalia Cir
Andover, MA 01810-6311
Phone (508) 451-7329

Other practice location 1

166 S River Rd Ste 220
Bedford, NH 03110-6928
Phone (603) 836-4112

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
LCSW2120852MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jtsj1 Enterprises LLC Mental Health PastSince Feb 10, 2026 Accepting new patients
Northeast Behavioral Health Corporation PastSince Sep 1, 2022 Accepting new patients

Organizations & group practices 2

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": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1629790928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 KALIA CIR",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018106311",
            "telephone_number": "508-451-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CHURCH ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018526113",
            "telephone_number": "508-451-7329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 S River Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106928",
            "country_code": "US",
            "telephone_number": "603-836-4112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACINNES",
        "first_name": "JESSIE",
        "middle_name": "KIMELMAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LCSW2120852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.