Individual provider Active NPI

Jenny Lynn Coleman, LSW

  • Social Worker
  • Webster Springs, WV
National Provider Identifier
1205253796
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
AP00941815 Issued in WV
Practice address
70 Parcoal Rd
Webster Springs, WV 26288-9767
Phone
(304) 847-5425
Fax
(304) 847-5422
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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 AP00941815 WV Primary

Addresses

Primary practice location

70 Parcoal Rd
Webster Springs, WV 26288-9767

Mailing address

131 Wellness Dr
Summersville, WV 26651-5402
Phone (304) 872-6503

Other practice location 1

804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone (304) 497-0500

Other practice location 2

131 Wellness Dr
Summersville, WV 26651-5402
Phone (304) 872-2659

Other practice location 3

704 3rd Ave
Marlinton, WV 24954-1142
Phone (304) 799-6865

Other names 1

  • Jenny Phares Former name

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
AP00941815WVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Camden on Gauley Medical Center Inc Past Accepting new patients
Camden on Gauley Medical Center Inc Past Accepting new patients

Organizations & group practices 2

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1205253796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 WELLNESS DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266515402",
            "telephone_number": "304-872-6503",
            "fax_number": "304-872-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PARCOAL RD",
            "city": "WEBSTER SPRINGS",
            "state": "WV",
            "postal_code": "262889767",
            "telephone_number": "304-847-5425",
            "fax_number": "304-847-5422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Industrial Park Rd",
            "address_purpose": "LOCATION",
            "city": "Maxwelton",
            "state": "WV",
            "postal_code": "249578066",
            "country_code": "US",
            "telephone_number": "304-497-0500",
            "fax_number": "304-497-0516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 Wellness Dr",
            "address_purpose": "LOCATION",
            "city": "Summersville",
            "state": "WV",
            "postal_code": "266515402",
            "country_code": "US",
            "telephone_number": "304-872-2659",
            "fax_number": "304-872-1685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Marlinton",
            "state": "WV",
            "postal_code": "249541142",
            "country_code": "US",
            "telephone_number": "304-799-6865",
            "fax_number": "304-799-6878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "AP00941815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "PHARES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Webster Springs, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.