Individual provider Active NPI

Monica Lynne Jenkins, LSW

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1053817601
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1701812 Issued in OH
Practice address
1110 Webster St
Dayton, OH 45404-1556
Phone
(937) 463-2955
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X S.1701812 OH Primary

Addresses

Primary practice location

1110 Webster St
Dayton, OH 45404-1556

Mailing address

1110 Webster St
Dayton, OH 45404-1556

Other practice location 1

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone (513) 939-0300

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1701812OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1053817601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 WEBSTER ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 WEBSTER ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041556",
            "telephone_number": "937-463-2955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251 Nilles Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450147205",
            "country_code": "US",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "MONICA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1701812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.