Jennifer J Ebbott, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7109-123 Issued in WI

Practice address

831 E Washington Ave
Madison, WI 53703-2935

Phone

(608) 255-7356

NPI assigned

Apr 25, 2008

Last updated

Apr 25, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Open Door Center for Change, LLCGroup PAC ID 2860598711, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Open Door Center for Change LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1215068069
  Medicare reassignment Care Compare group NPD
• The Rainbow Project Inc

  • Community/Behavioral Health Agency
  • Madison, WI
  • NPI 1861643348
  NPD (past)
• The Rainbow Project, Inc.

  • Community/Behavioral Health Agency
  • Madison, WI
  • NPI 1215177373
  NPD (past)

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1013182419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032935",
            "telephone_number": "608-255-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBBOTT",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7109-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40962600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley J Ebacher, PA-C
• Danielle R. Ebben, LCSW, SAC
• Johnathan D Ebben, MD, PHD
• Nathan James Ebben
• Jessica J. Ebbert, CRNA
• Shari Eberhardt
• Amanda Elyse Eberle, D.C.
• Brent J Eberle, RPH
• Michael Hermann Eberlein, MD
• Ann M Ebert, PHARMD

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.