Individual provider Active NPI

Jennelle Dawn Hindash, LCSW

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1033247275
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-06649 Issued in NM
Practice address
3855 Foothills Rd Ste C
Las Cruces, NM 88011-4772
Phone
(575) 496-7762
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Social Worker 104100000X C-06649 NM
Social Worker 104100000X M-05761 NM
Clinical Social Worker 1041C0700X C-06649 NM Primary

Addresses

Primary practice location

3855 Foothills Rd Ste C
Las Cruces, NM 88011-4772

Mailing address

3855 Foothills Rd Ste C
Las Cruces, NM 88011-4772
Phone (575) 386-5254

Other identifiers 2

IdentifierTypeStateIssuer
41676238MedicaidNM
17831237MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20100322000247 NM Practitioner - Clinical Social Worker 3577698141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3831 E Lohman Ave
Suite 204
Las Cruces, NM 88011-8447
Phone (575) 386-5254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-05761NMMDSocial Worker
C-06649NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Collective Wellness LLC Clinical CurrentSince Jul 1, 2020 Accepting new patients

Locations

3831 E Lohman Ave
Ste 204
Las Cruces, NM 88011
Phone (575) 386-5254

3855 Foothills Rd
Ste C
Las Cruces, NM 88011
Phone (575) 496-7762

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1033247275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 FOOTHILLS RD STE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114772",
            "telephone_number": "575-386-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 FOOTHILLS RD STE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114772",
            "telephone_number": "575-496-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDASH",
        "first_name": "JENNELLE",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2024-01-18",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "C-06649",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-05761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-06649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41676238",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17831237",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.