MEDICARE: JAIME PADMORE MSW,LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	128622	MA

General Provider Information

NPI Number	:	1386214336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME PADMORE MSW,LICSW

Provider Business Mailing Address
First Line	:	185 MAIN ST STE 40
Second Line	:
City	:	AVON
State	:	MA
Zip	:	02322-1452
Country	:	US
Telephone Number	:	857-302-5640
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 MAIN ST STE 40
Second Line	:
City	:	AVON
State	:	MA
Zip	:	02322-1452
Country	:	US
Telephone Number	:	781-519-9646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	11/29/2024

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