Individual provider Active NPI

Adella Jenny Jaeger, LCSW

  • Clinical Social Worker
  • Henderson, NV
National Provider Identifier
1194290692
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
85819 Issued in CA
Practice address
2520 Saint Rose Pkwy Ste 108
Henderson, NV 89074-7784
Phone
(844) 933-8224
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 85819 CA Primary

Addresses

Primary practice location

2520 Saint Rose Pkwy Ste 108
Henderson, NV 89074-7784

Mailing address

5404 Whitsett Ave # 191
Valley Village, CA 91607-1615
Phone (747) 205-0896

Other practice location 1

197 Andada Dr
Henderson, NV 89012-2496
Phone (818) 392-4214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201116002767 CA Practitioner - Clinical Social Worker 8224449665 Reassigns benefits to 2 organizations
I20210426002408 NV Practitioner - Clinical Social Worker 8224449665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11712 Moorpark St
Suite 101
Studio City, CA 91604-2155
Phone (747) 205-0896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85819CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Zeeva Behavioral Health, a Professional Licensed Clinical Soc Clinical CurrentSince Oct 1, 2020 Accepting new patients
Adella Jaeger LCSW, PC Clinical CurrentSince Jun 15, 2021 Accepting new patients
Zeeva Integrative Licensed Clinical Social Worker Services, PC Clinical CurrentSince Dec 12, 2020 Accepting new patients

Locations

11500 W Olympic Blvd
Ste 400
Los Angeles, CA 90064
Phone (310) 595-5984

11712 Moorpark St
Ste 101
Studio City, CA 91604
Phone (747) 205-0896

12087 Lopez Canyon Rd
Ste 128
Sylmar, CA 91342
Phone (310) 595-5984

5404 Whitsett Ave
Valley Vlg, CA 91607
Phone (818) 574-0078

2625 Wigwam Pkwy
Ste 108
Henderson, NV 89074
Phone (702) 451-1522

2520 Saint Rose Pkwy
Ste 108
Henderson, NV 89074
Phone (747) 205-0896

Organizations & group practices 3

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1194290692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 WHITSETT AVE # 191",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916071615",
            "telephone_number": "747-205-0896",
            "fax_number": "702-472-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY STE 108",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747784",
            "telephone_number": "844-933-8224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Andada Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890122496",
            "country_code": "US",
            "telephone_number": "818-392-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "ADELLA",
        "middle_name": "JENNY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "85819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.