Individual provider Active NPI

Jessica Clem, MSW, LCSW

  • Clinical Social Worker
  • Cary, NC
National Provider Identifier
1982376042
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CO11818 Issued in NC
Practice address
1250 SE Maynard Rd Ste 204
Cary, NC 27511-6947
Phone
(919) 948-7718
Fax
(919) 300-7943
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CO11818 NC Primary

Addresses

Primary practice location

1250 SE Maynard Rd Ste 204
Cary, NC 27511-6947

Mailing address

2612 Bloomsberry Ridge Dr
Fuquay Varina, NC 27526-7291
Phone (919) 592-8848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20211021000323 NC Practitioner - Clinical Social Worker 5092103234 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
Telehealth
Offers telehealth services
Group practices
Silver Linings for Seniors, IncGroup PAC ID 6103137112, 25 clinicians

Practice addresses (Care Compare)

1250 SE Maynard Rd
Suite 204
Cary, NC 27511-6947
Phone (919) 457-1598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CO11818NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Linings for Seniors, Inc. Clinical CurrentSince Oct 5, 2021 Accepting new patients
Kristin McArthur, MD, PLLC CurrentSince Oct 5, 2021 Accepting new patients

Locations

1250 SE Maynard Rd
Ste 204
Cary, NC 27511
Phone (919) 457-1598

Organizations & group practices 2

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1982376042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 BLOOMSBERRY RIDGE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267291",
            "telephone_number": "919-592-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 SE MAYNARD RD STE 204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116947",
            "telephone_number": "919-948-7718",
            "fax_number": "919-300-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "JESSICA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "CO11818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.