Individual provider Active NPI

Jennifer M. McCarthy, LICSW

  • Clinical Social Worker
  • Conway, NH
National Provider Identifier
1750488177
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1060 Issued in NH
Practice address
81 Washington St
Conway, NH 03818-6044
Phone
(603) 447-2453
Fax
(603) 447-2450
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 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 1060 NH Primary

Addresses

Primary practice location

81 Washington St
Conway, NH 03818-6044

Mailing address

PO Box 2726
Conway, NH 03818-2726
Phone (603) 447-2453

Other identifiers 1

IdentifierTypeStateIssuer
1060OtherNHLICSW LICENSURE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20080505000502 NH Practitioner - Clinical Social Worker 1153400916 Practice locations: Conway, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

81 Washington St
Conway, NH 03818-6044
Phone (603) 662-6394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1060NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Washington Valley Psychological Services, LLC Past Accepting new patients
Northern Human Services Past Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1750488177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2726",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038182726",
            "telephone_number": "603-447-2453",
            "fax_number": "603-447-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 WASHINGTON ST",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186044",
            "telephone_number": "603-447-2453",
            "fax_number": "603-447-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW LICENSURE NUMBER",
            "identifier": "1060",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, NH

Sources for this page

Verify at the official NPI Registry.