Jessica Hersom, LCSW, LADC is a medicare enrolled "Social Worker - Clinical" provider in Belfast, Maine. Her current practice location is
119 Northport Ave Fl 1, Belfast, Maine. You can reach out to her office (for appointments etc.) via phone at
(207) 570-8776.
Jessica Hersom is licensed to practice in Maine (license number LC20114) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1316442940.
Healthcare Provider's Profile
| Full Name | Jessica Hersom |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 119 Northport Ave Fl 1, Belfast, Maine |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1316442940
- Provider Enumeration Date: 03/26/2018
- Last Update Date: 03/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 4082002878
- Enrollment ID: I20211027003065
Medical Identifiers
Medical identifiers for Jessica Hersom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1316442940 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LC6782 (Maine) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CAC5848 (* (Not Available)) | Secondary |
| 104100000X | Social Worker | LM16932 (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | LC20114 (Maine) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Hersom allows following entities to bill medicare on her behalf.
| Entity Name | Mainehealth |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790265502
PECOS PAC ID: 7517860588
Enrollment ID: O20040701000166 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Hersom is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jessica Hersom, LCSW, LADC
15 Fawn Ct,
Bangor, ME 04401-2750
Ph: (207) 570-8776 | Jessica Hersom, LCSW, LADC
119 Northport Ave Fl 1,
Belfast, ME 04915-6069
Ph: (207) 570-8776 |
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