Jennifer Carolyn Skinner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C1277 Issued in MS

Practice address

350 North Mart Plaza
Suite M
Jackson, MS 39206

Phone

(601) 362-8850

Fax

(601) 981-0452

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jennifer Carolyn Skinner Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003984196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1572 SCHOOLVIEW DRIVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-366-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NORTH MART PLAZA",
            "address_2": "SUITE M",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39206",
            "telephone_number": "601-362-8850",
            "fax_number": "601-981-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JENNIFER",
        "middle_name": "CAROLYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C1277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124149",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SKINNER",
            "middle_name": "CAROLYN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Emily Gordon Skelton, FNP-C
• Jefferson Pinckney Wilkerson Skelton Jr., MD
• Megan E Skelton, PTA
• Thomas N. Skelton, MD
• Thomas Nichols Skelton Jr., MD
• Lauren Skinner
• Craig Stanley Skousen, MD
• Megan Egbert Slade, F.N.P.
• Angela Slater, AGNP, C
• Angela Slater, LPN-230804

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.