| Jamie L King Licsw, Llc | |
|
89 N Main St # 206 Andover MA 01810-6503 | |
| (978) 409-7974 | |
| Not Available |
| Full Name | Jamie L King Licsw, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 89 N Main St # 206, Andover, Massachusetts |
| Authorized Official Name and Position | Jamie L King (OWNER) |
| Authorized Official Contact | 9784097974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jamie L King Licsw, Llc 89 N Main St # 206 Andover MA 01810-6503 Ph: (978) 409-7974 | Jamie L King Licsw, Llc 89 N Main St # 206 Andover MA 01810-6503 Ph: (978) 409-7974 |
| NPI Number | 1518778646 |
|---|---|
| Provider Enumeration Date | 01/17/2025 |
| Last Update Date | 01/17/2025 |
| Certification Date | 01/17/2025 |
| Medicare PECOS PAC ID | 0547799397 |
|---|---|
| Medicare Enrollment ID | O20250124000221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518778646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jamie L King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013347798 PECOS PAC ID: 5991001026 Enrollment ID: I20160315002347 |
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