Active NPI
Lailey Jenkins, LICSW
- Clinical Social Worker
- Bremerton, WA
National Provider Identifier
1174074322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW 00008654
- Practice address
- 555 Pacific Ave
Suite 202
Bremerton, WA 98337-1903 - Phone
- (360) 782-1700
- NPI assigned
- Oct 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW 00008654 | WA | Primary |
Addresses
Primary practice location
555 Pacific Ave
Suite 202
Bremerton, WA 98337-1903
Mailing address
555 Pacific Ave
Suite 202
Bremerton, WA 98337-1903
Phone (360) 782-1700
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
| License | State | Type | Specialty |
|---|---|---|---|
| LW 00008654 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1174074322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 PACIFIC AVE",
"address_2": "SUITE 202",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983371903",
"telephone_number": "360-782-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 PACIFIC AVE",
"address_2": "SUITE 202",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983371903",
"telephone_number": "360-782-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "LAILEY",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW 00008654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.