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JACQUELYN MARY MAYO LICSW
NPI 1760965479
Social Worker - Clinical in Bedford, NH

Active since September 09, 2018PECOS Enrolled
173 SOUTH RIVER ROAD, UNIT 3, BEDFORD, NH 03110(603) 472-5279(603) 488-1682 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 28, 2025, Jul 14, 2023, Sep 9, 2018 (3 updates tracked since 2018).

About Jacquelyn Mary Mayo Licsw NPPES

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

JACQUELYN MARY MAYO LICSW (NPI 1760965479) is an individual clinical provider in Bedford, New Hampshire, licensed in Massachusetts (12336) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lowell.

NPPES Registry Identity

NPI1760965479
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJACQUELYN MARY MAYOCredential: LICSW
Location Address173 SOUTH RIVER ROAD, UNIT 3Bedford, NH 03110
Mailing Address173 South River Road, Unit 3Bedford, NH 03110 · (603) 472-5279 · Fax (603) 488-1682
Phone(603) 472-5279
Fax(603) 488-1682
Sole ProprietorYes
Enumeration DateSeptember 9, 2018
Last NPPES UpdateMay 28, 20253 updates tracked since enumeration
NPPES CertifiedJuly 14, 2023
✔ NPI 1760965479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in MA · 12336✔ Licensed in NH · 2935✔ Licensed in MA · 000224046
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.
173 SOUTH RIVER ROAD, Bedford, NH 03110
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Other Names 1

Former Name (1)Jacquelyn Mayo Georgallas Licsw

Secondary Practice Location 1

Location 122 Old Canal DrLowell, MA 01851-2730 · Phone (978) 453-6800

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacquelyn Mary Mayo Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jacquelyn Mayo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sb Transitional Sub, LLC
65 mi
Mental Health (Including Community Mental Health Center)
1115 W CHESTNUT ST
Brockton, MA 02301
  • Reassigned Medicare billing, Massachusetts enrollment
  • 120 clinicians in this Medicare group
NPI 1962091173 (508) 521-2200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03110 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 $57.75 – $174.26
Typical copayment $0.00 (range $14.43 – $43.56)
Most-billed visit code NA
Established Patient
$71.85 typical visit price
range $18.70 – $142.15
Typical copayment $17.96 (range $4.67 – $35.53)
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Mayo's NPI number?

The NPI number for Jacquelyn Mayo is 1760965479. It was assigned to this individual provider in the NPPES registry on September 9, 2018. The provider is also known as Jacquelyn Mayo Georgallas Licsw.

Where is Jacquelyn Mayo located?

Jacquelyn Mayo practices at 173 South River Road Unit 3, Bedford, NH 03110. The listed phone number is (603) 472-5279.

What is Jacquelyn Mayo's specialty?

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

Is Jacquelyn Mayo enrolled in Medicare?

Yes. Jacquelyn Mayo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacquelyn Mayo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Mayo reassigns Medicare benefits to Sb Transitional Sub, LLC (Brockton, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacquelyn Mayo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacquelyn Mayo accept?

Health plans from Harvard Pilgrim Health Care list Jacquelyn Mayo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacquelyn Mayo was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.