Jody Jansen LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC5633 Issued in ME

Legal business name

JODY JANSEN LCSW LLC

Practice address

62 Portland Rd
Suite 6
Kennebunk, ME 04043-6658

Phone

(207) 251-9118

Fax

(207) 517-6241

NPI assigned

Nov 13, 2014

Last updated

Dec 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jody Jansen, LCSWNPI 1407901473

Title

Clinical Social Work

Phone

(207) 251-9118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jody Jansen LCSW Other name

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jody Jansen, LCSW

  • Clinical Social Worker
  • Kennebunk, ME
  • NPI 1407901473
  Medicare reassignment NPD Authorized official
• Nannette A Nero, MS, CAGS, LMFT

  • Marriage & Family Therapist
  • Kennebunk, ME
  • NPI 1205957719
  NPD (past)
• Andrea Beth Summer, L.C.P.C.

  • Mental Health Counselor
  • Saco, ME
  • NPI 1285777904
  NPD (past)

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1871999193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 RICHARDS AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015276",
            "telephone_number": "207-251-9118",
            "fax_number": "207-517-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 PORTLAND RD",
            "address_2": "SUITE 6",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436658",
            "telephone_number": "207-251-9118",
            "fax_number": "207-517-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODY JANSEN LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-13",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "JANSEN",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORK",
        "authorized_official_telephone_number": "207-251-9118",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0003644",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jody Jansen LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael R Ireland, FNP-C
• Megan Elise Jackins, CCC-SLP
• James R Cormier DMD LLC PA (Mousam River Dentistry)
• Jody Jansen, LCSW
• Cailen Jennings
• John P Gmeiner, PHD, PA
• Alla Johnson, SLP/CF
• Jonathan Shill MD
• Jonathan Shill MD PH.D, LLC
• Lorelyn M Jones

• Clinical Social Worker in Kennebunk, ME
• Providers in Kennebunk, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.