Jaclyn Vance, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3591C Issued in AL

Practice address

300 S. Twining St, BLDG 760
Montgomery, AL 36112-6219

Phone

(334) 953-5430

NPI assigned

Apr 9, 2014

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1134548860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S. TWINING ST, BLDG 760",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361126219",
            "telephone_number": "334-953-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S. TWINING ST, BLDG 760",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361126219",
            "telephone_number": "334-953-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JACLYN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3591C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neetha Vadde, MD
• Yamairi Alexandra Valdez
• Valiant Home Care LLC
• Amanda Vallandingham, LMT
• Caroline Evans Van Hooser, CRNP
• Richard K. Vann, D.M.D.
• Jogy Varghese, M.D.
• Jonathan Mac Varner, M.D.
• Karen Vaughan
• Wallace Carroll Vaughan Jr., M.D.

• Clinical Social Worker in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.