Active NPIIndividual providerSole proprietor

Jacquelyn M Mayo, LICSW

Social Worker, Clinical in Bedford, New Hampshire

NPI Number1760965479
Practice location
173 South River Road, Unit 3, Bedford, NH 03110
Fax
603-488-1682
Last updated
May 28, 2025

Jacquelyn Mary Mayo is a Social Worker, Clinical based in Bedford, NH. Jacquelyn Mary Mayo practices in Bedford, NH and has the professional credentials of LICSW. The NPI Number for Jacquelyn Mary Mayo is 1760965479 and holds a License No. 2935 (NH). The current practice location address for Jacquelyn Mary Mayo is 173 South River Road, Unit 3, Bedford, NH 03110 and can be reached out via phone at 603-472-5279 and via fax at 603-488-1682.

Provider Profile Details

NPI Number
1760965479
Provider Name
Jacquelyn Mary Mayo
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
173 South River Road, Unit 3, Bedford, NH 03110
Phone Number
603-472-5279
Fax Number
603-488-1682
Primary Taxonomy
Social Worker, Clinical · 1041C0700X
Sole Proprietor
Yes
Other Names
Jacquelyn Mayo Georgallas, LICSW (Former Name)
Provider Enumeration Date
September 9, 2018
Last Update Date
May 28, 2025
Certification Date
July 14, 2023
NPI Status
Active

Provider Business Practice Location Address Details

Address
173 South River Road
Unit 3
Bedford, NH 03110
Zip
03110
Phone Number
603-472-5279
Fax Number
603-488-1682
Bedford, NH 03110Get directions →

Provider Business Mailing Address Details

Address
173 South River Road
Unit 3
Bedford, NH 03110
City
Bedford
State
NH
Zip
03110
Phone Number
603-472-5279
Fax Number
603-488-1682

License Information

License Number (1)
2935
License State (1)
NH
Taxonomy (1)
Social Worker, Clinical · 1041C0700X
License Number (2)
000224046
License State (2)
MA
Taxonomy (2)
Social Worker, Clinical · 1041C0700X
License Number (3)
12336
License State (3)
MA
Taxonomy (3)
Social Worker, Clinical · 1041C0700X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Jacquelyn M Mayo, LICSW?

The NPI number of Jacquelyn M Mayo, LICSW is 1760965479. It was assigned on September 9, 2018 and is currently active in the NPPES registry.

What is the specialty of Jacquelyn M Mayo, LICSW?

Jacquelyn M Mayo, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in NH under license number 2935.

Where does Jacquelyn M Mayo, LICSW practice?

The practice location is 173 South River Road, Unit 3, Bedford, NH 03110. The office can be reached at 603-472-5279 (phone) or 603-488-1682 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1760965479 directly on the NPPES registry website.

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