Individual provider Active NPI

Gena S Jennings, LLMSW

  • Social Worker
  • Detroit, MI
National Provider Identifier
1174037014
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801099288 Issued in MI
Practice address
882 Oakman Blvd Ste C
Detroit, MI 48238-4019
Phone
(313) 961-4890
NPI assigned
Nov 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801099288 MI Primary

Addresses

Primary practice location

882 Oakman Blvd Ste C
Detroit, MI 48238-4019

Mailing address

2415 Ferry Park St
Detroit, MI 48208-1101
Phone (313) 256-1086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801099288MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1174037014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 FERRY PARK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081101",
            "telephone_number": "313-256-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 OAKMAN BLVD STE C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482384019",
            "telephone_number": "313-961-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "GENA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801099288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.