Individual provider Active NPI

Jennifer Marie Brown, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1235485129
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015275 Issued in IL
Practice address
6886 S Harrier Loop
Tucson, AZ 85756-8611
Phone
(708) 821-4741
NPI assigned
Jul 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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 149015275 IL Primary

Addresses

Primary practice location

6886 S Harrier Loop
Tucson, AZ 85756-8611

Mailing address

6886 S Harrier Loop
Tucson, AZ 85756-8611
Phone (708) 821-4741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, AZ2 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
I20181130002178 IL Practitioner - Clinical Social Worker 5193069250 Practice locations: Monee, IL
I20210831000579 AZ Practitioner - Clinical Social Worker 5193069250 Practice locations: Tucson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5157 W Park LN
Monee, IL 60449-8706
Phone (708) 821-4741

6886 S Harrier Loop
Tucson, AZ 85756-8611
Phone (708) 821-4741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015275ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation, LLC 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": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1235485129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6886 S HARRIER LOOP",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857568611",
            "telephone_number": "708-821-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6886 S HARRIER LOOP",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857568611",
            "telephone_number": "708-821-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-28",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.