Nicole Jellinek, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW01854 Issued in RI

Practice address

229 Waterman Ave
Providence, RI 02911-1043

Phone

(401) 289-0884

NPI assigned

Sep 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Jewish Family Services

  • Mental Health Counselor
  • Providence, RI
  • NPI 1588673347
  NPD (past)

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1093909806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 WATERMAN AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029111043",
            "telephone_number": "401-289-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 WATERMAN AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029111043",
            "telephone_number": "401-289-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLINEK",
        "first_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111850",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Hughes, PSYD LLC
• Jeffrey Wishik MD
• Eliot Jekowsky, MD
• Elissa Jelalian, PHD
• Graham C. Jelley, PH.D
• Annabel Jeng, NP
• Dawn Marie Jenison, PA-C
• Gracie Adair Jenkins, MD
• Melissa A. Jenkins, PHD
• Theresa E Jenner, LICSW

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.