Individual provider Active NPI

Cary Jenson, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1811092190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC7590 Issued in ME
Practice address
1048 Union St., Ste 5
Bangor, ME 04401-0000
Phone
(207) 945-5247
Fax
(207) 992-2154
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 LC7590 ME Primary

Addresses

Primary practice location

1048 Union St., Ste 5
Bangor, ME 04401-0000

Mailing address

1048 Union St., Ste 5
Bangor, ME 04401-0000
Phone (207) 945-5247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20221220000084 ME Practitioner - Clinical Social Worker 8820467566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC7590MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Hospital Corp CurrentSince Oct 1, 2022 Accepting new patients
Acadia Healthcare, Inc Past Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811092190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 UNION ST., STE 5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044010000",
            "telephone_number": "207-945-5247",
            "fax_number": "207-992-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 UNION ST., STE 5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044010000",
            "telephone_number": "207-945-5247",
            "fax_number": "207-992-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "CARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.