Individual provider Active NPI

Maureen C Smith

  • Clinical Social Worker
  • Danvers, MA
National Provider Identifier
1790826857
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1016954 Issued in MA
Practice address
140 Commonwealth Ave Ste 210
Danvers, MA 01923-3625
Phone
(978) 532-5444
Fax
(978) 532-6366
NPI assigned
Feb 10, 2007
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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 1016954 MA Primary

Addresses

Primary practice location

140 Commonwealth Ave Ste 210
Danvers, MA 01923-3625

Mailing address

23 Cherry St
Medford, MA 02155-2767
Phone (781) 395-0928

Other names 1

  • Ms. Maureen J Jette Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20051022000193 MA Practitioner - Clinical Social Worker 5395761977 Practice locations: Danvers, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

140 Commonwealth Ave
Suite 210
Danvers, MA 01923-3625
Phone 97853254443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gross Young Enterprises, Inc Past Accepting new patients

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": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1790826857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CHERRY ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021552767",
            "telephone_number": "781-395-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COMMONWEALTH AVE STE 210",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233625",
            "telephone_number": "978-532-5444",
            "fax_number": "978-532-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MAUREEN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1016954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "JETTE",
            "middle_name": "J",
            "prefix": "MS.",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.