Individual provider Active NPI

Jane K Desmarais, LICSW

  • Clinical Social Worker
  • Springfield, MA
National Provider Identifier
1730301110
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111350 Issued in MA
Practice address
1049 Main St
Springfield, MA 01103-2114
Phone
(413) 739-1100
Fax
(413) 304-4666
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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 111350 MA Primary

Addresses

Primary practice location

1049 Main St
Springfield, MA 01103-2114

Mailing address

1049 Main St
Springfield, MA 01103-2114
Phone (413) 739-1100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
111350MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1730301110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011032114",
            "telephone_number": "413-739-1100",
            "fax_number": "413-304-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011032114",
            "telephone_number": "413-739-1100",
            "fax_number": "413-304-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMARAIS",
        "first_name": "JANE",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.