Jennelle Rachel Whitcomb, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R035814 Issued in NY

Practice address

2128 Elmwood Ave
Buffalo, NY 14207-1910

Phone

(716) 874-4500

Fax

(716) 874-3195

NPI assigned

Feb 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennelle Rachel Bloomberg-Whitcomb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• People Inc.

  • Clinic/Center
  • Buffalo, NY
  • NPI 1497351787
  NPD
• The Dale Association, Inc.

  • Mental Health Counselor
  • North Tonawanda, NY
  • NPI 1962407783

  Clinical

  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1184766800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071910",
            "telephone_number": "716-874-4500",
            "fax_number": "716-874-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 ELMWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071910",
            "telephone_number": "716-874-4500",
            "fax_number": "716-874-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITCOMB",
        "first_name": "JENNELLE",
        "middle_name": "RACHEL",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R035814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465154",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "3300881570",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNELLE",
            "last_name": "BLOOMBERG-WHITCOMB",
            "middle_name": "RACHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nishant Whig, MBBS
• Beth Anne Whipple, MS CCC/SLP
• John Whipple, LMT
• Jerika Whitaker
• April Whitcomb, OTR/L
• Stephanie Whitcomb
• Laura E. Whitcroft, PTA
• Laurie Ann White Abbatessa, NP
• Alexis Taylor White, PHARMD
• Ann M White

• Clinical Social Worker in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.