Individual provider Active NPI

Jennie L Barnes, LCSW

  • Clinical Social Worker
  • Waterville, ME
National Provider Identifier
1730558164
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC16895 Issued in ME
Practice address
325 Main St Ste 155
Waterville, ME 04901-4922
Phone
(207) 649-4790
Fax
(844) 450-1757
NPI assigned
Sep 16, 2015
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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 LC16895 ME Primary

Addresses

Primary practice location

325 Main St Ste 155
Waterville, ME 04901-4922

Mailing address

325 Main St Ste 155
Waterville, ME 04901-4922
Phone (207) 649-4790

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180928000568 ME Practitioner - Clinical Social Worker 7911258058 Practice locations: Winslow, ME

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Counseling Clinical CurrentSince Nov 3, 2024 Accepting new patients

Locations

13 Railroad Sq
#1
Waterville, ME 04901
Phone (207) 200-4548

325 Main St
Waterville, ME 04901
Phone (207) 649-4790

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1730558164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAIN ST STE 155",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014922",
            "telephone_number": "207-649-4790",
            "fax_number": "844-450-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAIN ST STE 155",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014922",
            "telephone_number": "207-649-4790",
            "fax_number": "844-450-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "JENNIE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC16895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.