Provider Demographics
NPI:1649330028
Name:PIERCE, JAMIE (LICSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:DWORK LEVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:10 CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3006
Mailing Address - Country:US
Mailing Address - Phone:857-636-2523
Mailing Address - Fax:
Practice Address - Street 1:10 CLIFF ST
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3006
Practice Address - Country:US
Practice Address - Phone:857-636-2523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1121921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA62-00502OtherEVERCARE
MA62-00502OtherEVERCARE