Individual provider Active NPI

Jennifer Anne Malnar, LCSW, MSW

  • Clinical Social Worker
  • Streator, IL
National Provider Identifier
1063608222
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
202 S Vermillion St
Streator, IL 61364-4417
Phone
(815) 672-1802
Fax
(815) 672-1860
NPI assigned
Sep 21, 2007
Last updated
Feb 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

202 S Vermillion St
Streator, IL 61364-4417

Mailing address

202 S Vermillion St
Streator, IL 61364-4417
Phone (815) 672-1802

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

State licenses

LicenseStateTypeSpecialty
149.012628ILMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1063608222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S VERMILLION ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613644417",
            "telephone_number": "815-672-1802",
            "fax_number": "815-672-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S VERMILLION ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613644417",
            "telephone_number": "815-672-1802",
            "fax_number": "815-672-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALNAR",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.