Individual provider Active NPI

Jessica Fancher Cole, DSW, LICSW

  • Clinical Social Worker
  • Charles Town, WV
National Provider Identifier
1164003471
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00944444 Issued in WV
Practice address
113 W Liberty St Ste 202
Charles Town, WV 25414-1548
Phone
(304) 629-0900
NPI assigned
Apr 19, 2021
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X DP00944444 WV Primary

Addresses

Primary practice location

113 W Liberty St Ste 202
Charles Town, WV 25414-1548

Mailing address

PO Box 3314
Shepherdstown, WV 25443-3314
Phone (304) 629-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20210721001258 WV Practitioner - Clinical Social Worker 0244633725 Practice locations: Charles Town, WV; Martinsburg, WV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Martinsburg, WV 25404
Phone (304) 629-9000

113 W Liberty St
Suite 202
Charles Town, WV 25414-1548
Phone (304) 629-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1164003471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3314",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254433314",
            "telephone_number": "304-629-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W LIBERTY ST STE 202",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141548",
            "telephone_number": "304-629-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "JESSICA",
        "middle_name": "FANCHER",
        "credential": "DSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00944444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles Town, WV

Sources for this page

Verify at the official NPI Registry.