Jacqueline Martino, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110203 Issued in MA

Practice address

1132 Westfield St
West Springfield, MA 01089

Phone

(413) 592-1980

Fax

(413) 439-0096

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline McLean Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ann E Drouilhet

  • Community/Behavioral Health Agency
  • Framingham, MA
  • NPI 1831510015
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790900397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CARDINAL ROAD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01602",
            "telephone_number": "508-791-8243",
            "fax_number": "508-519-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 WESTFIELD ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "JACQUELINE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MCLEAN",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catherine E Martin
• Heather Martin, BCBA
• Thomas Martin
• Anna Lee Martinez, BSW, CHW
• Steven Martinez
• Jennifer Massa, NP
• Carrie L Massai
• Destiny M Massey
• Marylou Masterpole, LICSW
• Michael Mastroianni

• Clinical Social Worker in West Springfield, MA
• Providers in West Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.