Active NPI
Jenna Brown
- Social Worker
- Xenia, OH
National Provider Identifier
1245880178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1904334
- Practice address
- 36 N Detroit St
Xenia, OH 45385-2909 - Phone
- (937) 610-4673
- NPI assigned
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1904334 | OH | Primary |
Addresses
Primary practice location
36 N Detroit St
Xenia, OH 45385-2909
Mailing address
1459 Holly Bush Dr Apt B
Fairborn, OH 45324-6587
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1904334 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Decoach Team LLC | Current | Accepting new patients |
Locations
36 N Detroit St
Xenia, OH 45385
Phone (937) 610-4673
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Cincinnati, OH
- NPI 1366992224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1245880178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1459 HOLLY BUSH DR APT B",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453246587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 N DETROIT ST",
"city": "XENIA",
"state": "OH",
"postal_code": "453852909",
"telephone_number": "937-610-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-12",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1904334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Xenia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.