Jennifer Ann Archer, LSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

33011737A Issued in IN

Practice address

611 Lincoln Way E Ste 200
South Bend, IN 46601-3215

Phone

(574) 360-4066

Fax

(866) 843-2486

NPI assigned

Sep 19, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Center for Positive Change, Inc

  • Mental Health Counselor
  • South Bend, IN
  • NPI 1326392150
  NPD (past)

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1083492177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E OAKSIDE ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141112",
            "telephone_number": "574-229-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 LINCOLN WAY E STE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013215",
            "telephone_number": "574-360-4066",
            "fax_number": "866-843-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "33011737A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Appraise Behavioral Health
• Aprels Private Care
• John G Aranda, MD
• Sara Elizabeth Arbogast, NP
• Arcadia Healthcare Solutions, Inc.
• Lewelyn Arevalo, PT
• Daniel Abdel-Karim Armounfelder, MD, MPH
• Tyrone Arteese Armstead, RPH, MBA
• Amandajo Arndt, RBT
• Brook Elizabeth Arney, NP

• Mental Health Counselor in South Bend, IN
• Providers in South Bend, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.