Jessica Sheridan, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005777 Issued in GA

Practice address

104 Pilgrim Village Dr Ste 300
Suite 4245
Cumming, GA 30040-9232

Phone

(678) 595-2020

Fax

(470) 297-3685

NPI assigned

Sep 2, 2014

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

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

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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 and National Provider Directory roles.

• Therapeutic Impressions LLC

  • Clinical Social Worker
  • Cumming, GA
  • NPI 1134661945
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1164822623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 KAYAK WAY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300288915",
            "telephone_number": "678-595-2020",
            "fax_number": "470-297-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PILGRIM VILLAGE DR STE 300",
            "address_2": "SUITE 4245",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409232",
            "telephone_number": "678-595-2020",
            "fax_number": "470-297-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "JESSICA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "MSW005974",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "005777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Sheahon, PHARMD
• Mallory S Sheehan, FNP-C
• Lauren Wilkinson Shefrin, D.D.S.
• Antoinette Shell, M.A., CCC-SLP
• Wesley J Shelnutt, DMD
• Meeta Sheth
• Arielle Jessica Shetty, AG-ACNP
• Natalie Shih
• Mimi Shin, LMSW
• William K Shin, DDS

• Clinical Social Worker in Cumming, GA
• Providers in Cumming, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.