Individual provider Active NPI

Jennifer Duletski, LSW

  • Social Worker
  • Mandan, ND
National Provider Identifier
1194135616
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4092 Issued in ND
Practice address
200 2ND Ave NW
Mandan, ND 58554-3124
Phone
(701) 667-3338
Fax
(701) 667-3384
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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 4092 ND Primary

Addresses

Primary practice location

200 2ND Ave NW
Mandan, ND 58554-3124

Mailing address

200 2ND Ave NW
Mandan, ND 58554-3124
Phone (701) 667-3338

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
4092NDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Morton County Social Services Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1194135616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 2ND AVE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543124",
            "telephone_number": "701-667-3338",
            "fax_number": "701-667-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 2ND AVE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543124",
            "telephone_number": "701-667-3338",
            "fax_number": "701-667-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULETSKI",
        "first_name": "JENNIFER",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "4092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.