Jill B Gardner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC23944 Issued in ME

Practice address

78 Larkin St Apt 2
Bangor, ME 04401-6214

Phone

(207) 478-7785

NPI assigned

Nov 3, 2016

Last updated

Oct 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1720530041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 LARKIN ST APT 2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016214",
            "telephone_number": "207-478-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 LARKIN ST APT 2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016214",
            "telephone_number": "207-478-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JILL",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC6547",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC23944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadvi Ganesh, MD
• Mohamedazhar Gangat, M.D.
• Imi Ganz, PHD
• Alexandra Gardiner, MS
• Charles H Gardner Jr., LADC
• Karen L Gardner, LCSW
• Michelle A Gardner, FNP-BC
• Michelle W Gardner, M.D.
• Vernon Trip A Gardner, MD
• Sadie Raquel Garita

• Clinical Social Worker in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.