Jennswood Enterprise LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

JENNSWOOD ENTERPRISE LLC

Doing business as

Woodhaven Behavioral LLC

Practice address

100 Executive Dr Ste D
Lafayette, IN 47905-4863

Phone

(765) 537-3880

Fax

(765) 548-4332

NPI assigned

Jun 3, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Sue WoodNPI 1255039244

Title

Ceo

Phone

(765) 586-4764

Specialties & licenses 4

Addresses

Other names 1

• Woodhaven Behavioral LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Sue Wood, APRN PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, IN
  • NPI 1255039244
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742083200000",
    "number": "1023859436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 S 350 E",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479098112",
            "telephone_number": "765-586-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE DR STE D",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054863",
            "telephone_number": "765-537-3880",
            "fax_number": "765-548-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNSWOOD ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-586-4764"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodhaven Behavioral LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodhaven Behavioral LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jerry A Jefson, MD
• Kimberly K Jefvert, FNP-BC
• Kimberley L Jelinek Allen, FNP
• Deborah L Jenkins, RPH
• Eden Jenkins
• Junyoung Jeon, RN
• Kayla Denise Jewell, RD
• Govind Jha
• Jianhua Jin, LAC, PH.D.
• Hongkui Jing, M.D., PH.D.

• Multi-Specialty Clinic/Center in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Multi-Specialty Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.