JESSICA D HERSOM LCSW, LADC
NPI 1316442940
Social Worker - Clinical in Belfast, ME

Q: What is Jessica Hersom's NPI number?

The NPI number for Jessica Hersom is 1316442940. It was assigned to this individual provider in the NPPES registry on March 26, 2018. The provider is also known as Jessica Donna Hersom Ladc.

Q: What is Jessica Hersom's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Hersom was last updated on January 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 26, 2018PECOS EnrolledAccepts Medicare Assignment

98.06/100

CMS Quality Rating

119 NORTHPORT AVE FL 1, BELFAST, ME 04915(207) 505-4567(207) 536-2794 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 22, 2026, Mar 28, 2023, Sep 6, 2021 and 1 more (4 updates tracked since 2018).

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About Jessica D Hersom Lcsw, Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA D HERSOM LCSW, LADC (NPI 1316442940) is an individual clinical provider in Belfast, Maine, licensed in Maine (LC20114) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, is affiliated with Waldo County General Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1316442940

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameJESSICA D HERSOMCredential: LCSW, LADC

Location Address119 NORTHPORT AVE FL 1Belfast, ME 04915-6069

Mailing Address119 Northport Ave Fl 1Belfast, ME 04915-6069 · (207) 505-4567 · Fax (207) 536-2794

Phone(207) 505-4567

Fax(207) 536-2794

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateMarch 26, 2018

Last NPPES UpdateJanuary 22, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2026

✔ NPI 1316442940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in ME · LC20114

Definition

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.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LC6782 (ME)

119 NORTHPORT AVE FL 1, Belfast, ME 04915

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Other Names 1

Other Name (5)Jessica Donna Hersom Ladc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessica D Hersom Lcsw, Ladc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082002878

PECOS Enrollment IDI20211027003065

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Waldo County General Hospital

Critical Access Hospitals · Belfast, ME

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number201312

Location118 Northport AveBelfast, ME 04915 · Waldo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04915 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $53.26 – $162.77

Typical copayment $0.00 (range $13.31 – $40.69)

Most-billed visit code NA

Established Patient

$66.74 typical visit price

range $16.90 – $132.79

Typical copayment $16.68 (range $4.22 – $33.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.06/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.13

Promoting Interoperability

100

Improvement Activities

Leave this field empty

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAYMOND JOSEPH HOWARD MD

Family Medicine