Jina Phillips Lewallen, PHD, LCSW, MA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2142-C Issued in AR

Practice address

26493 E University Dr Apt 1148
Aubrey, TX 76227-1675

Phone

(501) 317-8417

NPI assigned

Aug 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255522694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26493 E UNIVERSITY DR APT 1148",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "762271675",
            "telephone_number": "501-317-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26493 E UNIVERSITY DR APT 1148",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "762271675",
            "telephone_number": "501-317-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWALLEN",
        "first_name": "JINA",
        "middle_name": "PHILLIPS",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2142-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00428989",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255522694",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Aubrey, TX
• Providers in Aubrey, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.