Juliette Jennings

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-38770 Issued in ID

Practice address

2031 E Quail Run Rd
Emmett, ID 83617-5059

Phone

(208) 365-2525

Fax

(208) 365-2234

NPI assigned

Jun 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Services Treatment

  • Mental Health Counselor
  • Emmett, ID
  • NPI 1083981146
  NPD

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1235755232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 E QUAIL RUN RD",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836175059",
            "telephone_number": "208-365-2525",
            "fax_number": "208-365-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 E QUAIL RUN RD",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836175059",
            "telephone_number": "208-365-2525",
            "fax_number": "208-365-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JULIETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-38770",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "LMSW-38770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE TO PRACTICE",
            "identifier": "LMSW-38770",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WITS",
            "affiliation": "N",
            "endpointDescription": "H&W System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2031 E Quail Run Rd",
            "city": "Emmett",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836175059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ikdo Emmett LLC
• Independent School District of Emmett #221
• Kenneth Roy Inselman, R.PH
• Lisa Isaksen, NP-C, PMHNP-BC
• Jeffrey L Henken DDS
• Logan Johnson, LMSW
• Jonathan Barrus DO PC
• Hailey Lucile Kahre
• Christopher Kimball, OD
• King Physical Therapy P.C.

• Social Worker in Emmett, ID
• Providers in Emmett, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.