Individual provider Active NPI

Jenifer Rae Brake Jenshoej, LGSW

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1225569460
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20860 Issued in MD
Practice address
6802 McClean Blvd
Baltimore, MD 21234-7260
Phone
(410) 444-3800
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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 20860 MD Primary

Addresses

Primary practice location

6802 McClean Blvd
Baltimore, MD 21234-7260

Mailing address

6802 McClean Blvd
Baltimore, MD 21234-7260
Phone (410) 444-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 25, 2024 through Jul 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20860MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1225569460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 MCCLEAN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212347260",
            "telephone_number": "410-444-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 MCCLEAN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212347260",
            "telephone_number": "410-444-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSHOEJ",
        "first_name": "JENIFER",
        "middle_name": "RAE BRAKE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.