Active NPI
Jolene N Pemberton, LMSW
- Social Worker
- Port Huron, MI
National Provider Identifier
1083878805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 511 Fort St RM 505
Port Huron, MI 48060-3936 - Phone
- (810) 966-0099
- Fax
- (810) 696-7339
- NPI assigned
- Jul 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
511 Fort St RM 505
Port Huron, MI 48060-3936
Mailing address
619 Lakeview Ave
Port Huron, MI 48060-2209
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renewal Christian Counseling Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Social Worker
- Mount Clemens, MI
- NPI 1548648322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740614400000",
"number": "1083878805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 LAKEVIEW AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480602209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 FORT ST RM 505",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480603936",
"telephone_number": "810-966-0099",
"fax_number": "810-696-7339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEMBERTON",
"first_name": "JOLENE",
"middle_name": "N",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-10",
"last_updated": "2025-02-27",
"certification_date": "2025-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
- Pediatric Dental Specilaist, P.C
- Brooke Amy Pegg, BSSW
- Alicia Pelc, LLMSW
- Mary Grace Pellerito Matteson
- Jacob James Pelzer, LLMSW, RSST
- Anne Rosemarie Penn, MA LPC
- Teisha Pennywell-King
- Percy H, McDonald, M.D., P.C.
- Ashan Perera, MD
- Peridontic Associates of Port Huron PLLC (Periodontic Associates of Port Huron)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.