Jason D Hennick, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 28047 Issued in CA

Practice address

3255 Wing St
San Diego, CA 92110-4638

Phone

(619) 521-3939

Fax

(619) 521-3935

NPI assigned

Feb 26, 2007

Last updated

Jul 24, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Through Life Counseling, Inc.Group PAC ID 5799200846, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Through Life Counseling, Inc.

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1801385745

  Clinical

  Medicare reassignment Care Compare group NPD
• San Diego Youth Services

  • Case Manager/Care Coordinator
  • San Diego, CA
  • NPI 1477891257
  Authorized official Same address or phone

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1134255755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104638",
            "telephone_number": "619-521-3939",
            "fax_number": "619-521-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 WING ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104638",
            "telephone_number": "619-521-3939",
            "fax_number": "619-521-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNICK",
        "first_name": "JASON",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 28047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Hennessey, OT
• Cheryl Diane Hennessy
• Colleen Hennessy, M.S., L.P.C.C.
• Jordan Taylor Hennessy
• Lauren E. Hennessy, LCSW
• Natalie Hennig
• Matthew Thomas Hennigan
• Carly Hennigar
• Michael Andrew Henning
• Camille Ann Henninger, M.D.

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.