JESSICA REDIS (NPI# 1770778003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770778003 |
| Entity Type | Individual |
| Full Name | JESSICA REDIS |
| Practice Address |
205 Willow St 205 Willow Street South Hamilton MA 01982-2255 |
| Mailing Address |
205 Willow St Lahey Health Primary Care, Hamilton-wenham South Hamilton MA 01982-2255 |
| Practice Telephone | 9784687346 |
| Mailing Telephone | 9784687346 |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2016-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
116900 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | AGENCY MEDICARE # | WVE061 | 01 |
| NY | AGENCY MEDICAID # | 00355940 | 01 |
| NY | AGENCY NPI | 1285628552 | 01 |
| Street Address |
205 WILLOW ST 205 WILLOW STREET |
| City | SOUTH HAMILTON |
| State | MA |
| Zip Code | 01982-2255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639285562 | Andrew S Lenhardt | Family Medicine | 205 Willow St, South Hamilton, MA 01982-2255 | 2006-08-22 |
| 1811347750 | Samantha Keck | Dentist | 205 Willow St, South Hamilton, MA 01982-2255 | 2016-06-21 |
| 1871839464 | Magnuson Dental Group, PC | Dentist | 205 Willow St, Building B, South Hamilton, MA 01982-2255 | 2012-12-31 |
| 1063733731 | Laura S Eurich | Family Medicine | 205 Willow St, South Hamilton, MA 01982-2255 | 2010-06-17 |
| 1558522946 | Hayley Moak-blest | Family Medicine | 205 Willow St, South Hamilton, MA 01982-2255 | 2008-06-19 |
| 1205963717 | Pablo Polischuk | Psychologist | 205 Willow St, South Hamilton, MA 01982-2255 | 2007-02-28 |
| 1316048861 | Janice E Crognale | Family Medicine | 205 Willow St, Lahey Health Primary Care, Hamilton-wenham, South Hamilton, MA 01982-2255 | 2006-09-26 |
| 1952402745 | Timothy R Oman | Family Medicine | 205 Willow St, Building C, South Hamilton, MA 01982-2255 | 2006-09-26 |
| 1558460691 | Patricia C Payne | Nurse Practitioner | 205 Willow St, Building C, South Hamilton, MA 01982-2255 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187613 | Nancy Schneider-pruett | Clinical Neuropsychologist | The Neuropsychology Service, 100 Cummings Center, Beverly, MA 01982 | 2020-06-04 |
| 1063542686 | Sandra Dunbar Yearley | Social Worker | 5 Elm Street, Suite 6, Danvers, MA 01982 | 2007-03-06 |
| 1477639706 | Hugh M Taylor | Family Medicine | 15 Railroad Avenue, South Hamilton, MA 01982 | 2006-10-30 |
| 1982789764 | Cheryl Ruth Azlin | Psychologist | 203 Willow Street, Ste 1e, South Hamilton, MA 01982 | 2006-10-27 |
| 1952492100 | Nancy L West | Counselor | 205 B Willow Street, South Hamilton, MA 01982 | 2006-09-27 |
| 1306946736 | Cvs Pharmacy Inc | Pharmacy | 15 Walnut Rd Hamilton Plz Sc, South Hamilton, MA 01982 | 2006-09-25 |
| 1386651073 | Michael A Edwards | Family Medicine | 40-42 Asbury St, South Hamilton, MA 01982 | 2006-08-02 |
| 1154343028 | Laura Anne Vorrias | Dentist | 61 Railroad Ave, South Hamilton, MA 01982 | 2006-07-23 |
| 1245351923 | Samuel C Foster | Dentist | 78 Willow St, So Hamilton, MA 01982 | 2007-04-02 |
| 1386720613 | Andrew J Ting | Family Medicine | 15 Railroad Avenue, S Hamilton, MA 01982 | 2006-10-30 |
| Find all providers in zip 01982 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104126226 | Alison Elizabeth Trimby | Social Worker | 203 Willow St Ste 3, South Hamilton, MA 01982-2292 | 2010-10-22 |
| 1124336920 | Maryellen Fairchild Collamore | Social Worker | 42 Bay Rd # 4, South Hamilton, MA 01982-2202 | 2010-09-15 |
| 1801030416 | Patricia Axsom O'brien | Social Worker | 639 Bay Rd, South Hamilton, MA 01982-1006 | 2009-04-27 |
| 1891838645 | Robert Kaufman | Social Worker | 60 Railroad Ave, South Hamilton, MA 01982-2219 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417189 | Paula Mcmurrough | Social Worker | 91 Cumberland Ave, Attleboro, MA 02703-5602 | 2020-11-04 |
| 1538760707 | New England Cognitive Behavior Therapy Group Pllc | Social Worker | 57 Wells Ave Ste 1, Newton, MA 02459-3263 | 2020-11-04 |
| 1306446034 | Enact Health LLC | Social Worker | 221 Saint Mary St Unit 2, Needham, MA 02494-3165 | 2020-10-30 |
| 1265032189 | Pamela Killen | Social Worker | 63 Vestal St, Nantucket, MA 02554-2628 | 2020-10-29 |
| 1649870734 | Leeann Wojnowski Horner | Social Worker | 125 Winter St, Lincoln, MA 01773-3501 | 2020-10-28 |
| 1760082945 | Natalie Pierpont Waggaman | Social Worker | 34 Hamilton Rd, Waltham, MA 02453-1516 | 2020-10-28 |
| 1245830454 | Hope F. Schroy | Social Worker | 52 Cottage St, Wellesley, MA 02482 | 2020-10-27 |
| 1720688070 | Anne Marie Kaminski | Social Worker | 83 Wheelock Rd, C/o Anne Kaminski, Sutton, MA 01590-2431 | 2020-10-27 |
| 1245830488 | Authentic Care Counseling LLC | Social Worker | 935 Great Plain Ave # 296, Needham, MA 02492-3031 | 2020-10-27 |
| 1831799261 | Faran Asen | Social Worker | 664a Main St, Amherst, MA 01002-2440 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HAMILTON |
| Zip Code | 01982 |
Please comment or provide details below to improve the information on JESSICA REDIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.