Jennifer N Wickstrom, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801099354 Issued in MI

Practice address

301 S Crapo St
Mt Pleasant, MI 48858

Phone

(989) 772-5938

NPI assigned

Jul 8, 2013

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 names 1

• Jennifer N Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Mental Health for Central Michigan

  • Psychiatry Physician
  • Mt Pleasant, MI
  • NPI 1609412840

  Clinical

  NPD

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1245671171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S CRAPO ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582941",
            "telephone_number": "989-772-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S CRAPO ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-772-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKSTROM",
        "first_name": "JENNIFER",
        "middle_name": "N",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1302717",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARTIN",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Whitford Chiropractic Clinic
• Dennis Wayne Whitford, D.C.
• Seth Whiting
• Kathryn Whitson
• Whole Mind PLLC
• Lena Widman, DO
• Kyle Wieber
• Anne-Marie Julienne Wiggins, FNP-BC
• Janet Wight, BA
• Mandy Wigren

• Clinical Social Worker in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.