NPIMap

Individual provider Active NPI

Jennifer Shea, LICSW

  • Social Worker
  • Concord, MA
National Provider Identifier
1871776658
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
111 Old Road to 9 Acre Cor
Concord, MA 01742-4141
Phone
(978) 369-1113
Fax
(978) 369-0908
NPI assigned
Dec 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

111 Old Road to 9 Acre Cor
Concord, MA 01742-4141

Mailing address

111 Old Road to 9 Acre Cor
Concord, MA 01742-4141
Phone (978) 369-1113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
My Health101 PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1871776658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424141",
            "telephone_number": "978-369-1113",
            "fax_number": "978-369-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424141",
            "telephone_number": "978-369-1113",
            "fax_number": "978-369-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "JENNIFER",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.