Individual provider Active NPI

Jessica Hubley, LCSW

  • Clinical Social Worker
  • Auburn, ME
National Provider Identifier
1821371287
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC18261 Issued in ME
Practice address
600 Turner St
Auburn, ME 04210-5299
Phone
(207) 376-3233
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT4652 ME
Clinical Social Worker 1041C0700X LC18261 ME Primary

Addresses

Primary practice location

600 Turner St
Auburn, ME 04210-5299

Mailing address

11 Galeville St
Winthrop, ME 04364-3554
Phone (207) 931-7459

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
I20200115000789 ME Practitioner - Clinical Social Worker 7315372646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

306 Rodman Rd
Auburn, ME 04210-3830
Phone (207) 333-3278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC18261MEMDClinical Social Worker
MT4652MEMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Affiliates Maine, LLC CurrentSince Nov 3, 2019 Accepting new patients

Locations

306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1821371287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GALEVILLE ST",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043643554",
            "telephone_number": "207-931-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TURNER ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105299",
            "telephone_number": "207-376-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBLEY",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT4652",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC18261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.