Individual provider Active NPI

Jennifer Lynn McMinn, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1194869230
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3070 Issued in KY
Practice address
2950 Breckenridge LN
10 A
Louisville, KY 40220-1462
Phone
(502) 314-0100
Fax
(502) 454-7507
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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 3070 KY Primary

Addresses

Primary practice location

2950 Breckenridge LN
10 A
Louisville, KY 40220-1462

Mailing address

2950 Breckenridge LN
10 A
Louisville, KY 40220-1462
Phone (502) 314-0100

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
3070KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1194869230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 BRECKENRIDGE LN",
            "address_2": "10 A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201462",
            "telephone_number": "502-314-0100",
            "fax_number": "502-454-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 BRECKENRIDGE LN",
            "address_2": "10 A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201462",
            "telephone_number": "502-314-0100",
            "fax_number": "502-454-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMINN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.