Individual provider Active NPI

Jennette Hitchcock, LCSW

  • Clinical Social Worker
  • Presque Isle, ME
National Provider Identifier
1740395508
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC1715 Issued in ME
Practice address
180 Academy St Ste 2
Presque Isle, ME 04769-3183
Phone
(207) 554-2352
Fax
(207) 554-2351
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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 LC1715 ME Primary

Addresses

Primary practice location

180 Academy St Ste 2
Presque Isle, ME 04769-3183

Mailing address

180 Academy St Ste 3
Presque Isle, ME 04769-3183
Phone (207) 554-2352

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
LC1715MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aroostook Mental Health Services, Inc. Clinical CurrentSince Nov 12, 1999 Accepting new patients
Caribou Eyecare, P.a. Past Accepting new patients

Locations

43 Hatch Dr
Ste 310
Caribou, ME 04736
Phone (207) 493-3361

43 Hatch Dr
Caribou, ME 04736
Phone (207) 493-3361

180 Academy St
Ste 3
Presque Isle, ME 04769
Phone (207) 554-2352

180 Academy St
Ste 2
Presque Isle, ME 04769
Phone (207) 764-3319

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1740395508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ACADEMY ST STE 3",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693183",
            "telephone_number": "207-554-2352",
            "fax_number": "207-554-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ACADEMY ST STE 2",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693183",
            "telephone_number": "207-554-2352",
            "fax_number": "207-554-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHCOCK",
        "first_name": "JENNETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC1715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.