Jenna Katelyn Daley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P007622 Issued in NC

Practice address

19900 S Main St Ste 8&9
Cornelius, NC 28031-6512

Phone

(704) 892-9490

NPI assigned

Nov 27, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184969446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280360381",
            "telephone_number": "704-892-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 S MAIN ST STE 8&9",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316512",
            "telephone_number": "704-892-9490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "284 Executive Park Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280251831",
            "country_code": "US",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALEY",
        "first_name": "JENNA",
        "middle_name": "KATELYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P007622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cindy Custer, RD
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• Puja Dalal
• James David Dalmas, DAVID DALMAS, RPH
• Kathryn Grayce Dandrea, CRNA
• Daniel Scott Danford, DO
• Daniel D Skotzko DDS PA
• Daniel Max & Marcandrea, LLC

• Clinical Social Worker in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.