| Jill A. Grace Hersch, Licsw, Pc | |
|
3 Community Rd Marblehead MA 01945-2706 | |
| (541) 488-0883 | |
| (541) 488-0893 |
| Full Name | Jill A. Grace Hersch, Licsw, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 3 Community Rd, Marblehead, Massachusetts |
| Authorized Official Name and Position | Jill Alison Grace Hersch (PRESIDENT) |
| Authorized Official Contact | 5414880883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill A. Grace Hersch, Licsw, Pc 3 Community Rd Marblehead MA 01945-2706 Ph: (541) 488-0883 | Jill A. Grace Hersch, Licsw, Pc 3 Community Rd Marblehead MA 01945-2706 Ph: (541) 488-0883 |
| NPI Number | 1376359778 |
|---|---|
| Provider Enumeration Date | 12/10/2024 |
| Last Update Date | 12/10/2024 |
| Certification Date | 12/10/2024 |
| Medicare PECOS PAC ID | 5294263570 |
|---|---|
| Medicare Enrollment ID | O20250114003583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376359778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jill Alison Grace Hersch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992858997 PECOS PAC ID: 1557318748 Enrollment ID: I20250114003667 |
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