Elisa A. Jacome, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

118204 Issued in MA

Practice address

77 E Merrimack St
Lowell, MA 01852-1251

Phone

(978) 221-6923

NPI assigned

Feb 28, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vinfen Corporation

  • Community/Behavioral Health Agency
  • Cambridge, MA
  • NPI 1225168271
  NPD
• Optum Behavioral Care of Connecticut, P.C.

  • Counseling Psychologist
  • Woburn, MA
  • NPI 1205617370
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1972630416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E MERRIMACK ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01852",
            "telephone_number": "978-221-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E MERRIMACK ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521251",
            "telephone_number": "978-221-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOME",
        "first_name": "ELISA",
        "middle_name": "A.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Chang MD PC
• Gail Jackson, MA
• Chantal Jackunchuck
• Hollie Michelle Jacobs
• Steven D Jacobs, D.C.
• Alena Fatima Jaffri, PA
• Nawshin Jamil, DO
• Nersis Jamsakian
• Donna M. Janas, MA, LMHC
• Jane Wagema-Johnson

• Clinical Social Worker in Lowell, MA
• Providers in Lowell, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.