Individual provider Active NPI

Jeanie Kay McPherson, LCSW

  • Clinical Social Worker
  • Ellsworth, ME
National Provider Identifier
1811079510
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC6735 Issued in ME
Practice address
194 Main St
Ellsworth, ME 04605-1939
Phone
(207) 667-2119
Fax
(207) 667-7319
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 LC6735 ME Primary

Addresses

Primary practice location

194 Main St
Ellsworth, ME 04605-1939

Mailing address

PO Box 5425
Ellsworth, ME 04605-5425
Phone (207) 667-2119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: No
  • 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
I20070302000476 ME Practitioner - Clinical Social Worker 0244332682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Behavioral Healthcare, LLC CurrentSince Oct 4, 2010 Accepting new patients
Sweetser PastSince Mar 12, 2012 Accepting new patients
Possibilities Counseling Services, Inc. Past Accepting new patients

Locations

157 Park St
Ste 5
Bangor, ME 04401
Phone (207) 992-0410

222 Saint John St
Ste 113
Portland, ME 04102
Phone (207) 772-2440

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811079510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5425",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046055425",
            "telephone_number": "207-667-2119",
            "fax_number": "207-667-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 MAIN ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051939",
            "telephone_number": "207-667-2119",
            "fax_number": "207-667-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "JEANIE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

Verify at the official NPI Registry.