Jennifer L Allen

Individual provider Active NPI Clinical Social Worker · Eastvale, CA

NPI 1154913614 · NPPES record last updated Feb 5, 2021

Key facts

NPI
1154913614
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCSW87509 (CA)
Practice address
5482 E Homecoming Cir Apt C
Eastvale, CA 91752-3601
Phone
(951) 790-7536
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Talkspace Provider Network Ca PC (29 clinicians)

Practice addresses (Care Compare)

74876 Serrano Dr
Twentynine Palms, CA 92277-3740
Phone (212) 284-7206

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240418003559 CA Practitioner - Clinical Social Worker 8022457373 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LCSW87509CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Provider Network Ca PC Current
since Feb 27, 2024
Accepting new patients

Locations

2578 Broadway
#607
New York, NY 10025
Phone (516) 847-5432

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW87509 CA Yes

Addresses

Primary practice location

5482 E Homecoming Cir Apt C
Eastvale, CA 91752-3601

Mailing address

5482 E Homecoming Cir Apt C
Eastvale, CA 91752-3601
Phone (951) 790-7536

Other providers in Eastvale, CA

All providers in Eastvale, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.