Individual provider Active NPI

Jihan S Ward, LCSW

  • Social Worker
  • Lexington, MA
National Provider Identifier
1669773552
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
218262 Issued in MA
Practice address
186 Bedford St
Lexington, MA 02420-4436
Phone
(603) 858-4603
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X 218262 MA Primary

Addresses

Primary practice location

186 Bedford St
Lexington, MA 02420-4436

Mailing address

100 Main Street
3
Haverhill, MA 01832
Phone (603) 858-4603

Other identifiers 2

IdentifierTypeStateIssuer
1669773552MedicaidMA
1669773552MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210414001776 NY Practitioner - Clinical Social Worker 1850709791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearwater Counseling Associates LCSW PLLCGroup PAC ID 4082900188, 11 clinicians

Practice addresses (Care Compare)

10 Beadart PL
Hyde Park, NY 12538-1218
Phone (845) 490-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
218262MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Counseling Associates LCSW, PLLC CurrentSince Apr 1, 2021 Accepting new patients

Organizations & group practices 1

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": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1669773552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAIN STREET",
            "address_2": "3",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "01832",
            "telephone_number": "603-858-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 BEDFORD ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204436",
            "telephone_number": "603-858-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "JIHAN",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "218262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669773552",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669773552",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.