NPIMap

Organization Active NPI

Jessica Prodis Licsw

  • Clinical Social Worker
  • Holyoke, MA
National Provider Identifier
1780191726
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118495 Issued in MA
Legal business name
JESSICA PRODIS LICSW
Practice address
30 Florence Ave
Holyoke, MA 01040-1813
Phone
(413) 687-8239
NPI assigned
Dec 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Jessica Jeanne Prodis, LICSWNPI 1407166341
Title
Supervising Clinician
Phone
(413) 687-8239

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 118495 MA Primary

Addresses

Primary practice location

30 Florence Ave
Holyoke, MA 01040-1813

Mailing address

30 Florence Ave
Holyoke, MA 01040-1813

Other names 1

  • Center for Resilience Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1780191726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FLORENCE AVE",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010401813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FLORENCE AVE",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010401813",
            "telephone_number": "413-687-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA PRODIS LICSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-29",
        "last_updated": "2024-01-30",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "PRODIS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "SUPERVISING CLINICIAN",
        "authorized_official_telephone_number": "413-687-8239",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Resilience",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Holyoke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.