Individual provider Active NPI

Jessica Hendon, LMSW

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1033526744
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801096515 Issued in MI
Practice address
3820 Packard St Ste 250
Ann Arbor, MI 48108-5017
Phone
(734) 780-7338
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801096515 MI Primary

Addresses

Primary practice location

3820 Packard St Ste 250
Ann Arbor, MI 48108-5017

Mailing address

3820 Packard St Ste 250
Ann Arbor, MI 48108-5017
Phone (734) 249-0641

Other practice location 1

17940 Farmington Rd Ste 302
Livonia, MI 48152-3159
Phone (734) 526-1878

Other practice location 2

30000 Hiveley St
Inkster, MI 48141-1089
Phone (734) 728-3400

Other identifiers 1

IdentifierTypeStateIssuer
6801096515MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Emdr and Trauma Therapy CurrentSince Aug 14, 2022 Accepting new patients
Richard Kneip, PH.D., P.C. Past Accepting new patients

Locations

3820 Packard St
Ste 250
Ann Arbor, MI 48108
Phone (734) 476-5024

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1033526744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 PACKARD ST STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085017",
            "telephone_number": "734-249-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 PACKARD ST STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085017",
            "telephone_number": "734-780-7338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17940 Farmington Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481523159",
            "country_code": "US",
            "telephone_number": "734-526-1878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30000 Hiveley St",
            "address_purpose": "LOCATION",
            "city": "Inkster",
            "state": "MI",
            "postal_code": "481411089",
            "country_code": "US",
            "telephone_number": "734-728-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDON",
        "first_name": "JESSICA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801096515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801096515",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.