Jaclyn Hannan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1899 Issued in NH

Practice address

15 Ermer Rd
Suite 215
Salem, NH 03079-1271

Phone

(603) 890-6767

Fax

(603) 893-6767

NPI assigned

Nov 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1871967380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ERMER RD",
            "address_2": "SUITE 215",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030791271",
            "telephone_number": "603-890-6767",
            "fax_number": "603-893-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ERMER RD",
            "address_2": "SUITE 215",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030791271",
            "telephone_number": "603-890-6767",
            "fax_number": "603-893-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAN",
        "first_name": "JACLYN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary A Hamlett, AS
• Heather D Hancock, MSPT, CCCE, CCI
• McKenzie Anne Haney
• Patricia Hanley, COTA/L
• Robert Michael Hanlon, DC
• Daniel Hannon, PHD, LCMHC
• Karen J Hansly, OT
• Anthony G Haralabatos, NP
• Lauren R Hardacre, M.S., CCC-SLP
• Crystal B Harding, LCMHC, LMHC

• Clinical Social Worker in Salem, NH
• Providers in Salem, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.