Active NPI
Jessica Van Ness Jacobs, LCSW
- Clinical Social Worker
- Greenwood, IN
National Provider Identifier
1255733689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34008517A
- Practice address
- 313 Western Blvd Ste E
Greenwood, IN 46142-9217 - Phone
- (317) 426-1847
- NPI assigned
- Sep 17, 2014
- Last updated
- Jan 22, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34008517A | IN | Primary |
Addresses
Primary practice location
313 Western Blvd Ste E
Greenwood, IN 46142-9217
Mailing address
313 Western Blvd Ste E
Greenwood, IN 46142-9217
Phone (317) 426-1847
Other practice location 1
111 South St
Somerville, MA 02143-4297
Phone (617) 354-2275
Other names 1
- Jessica Morgan Van Ness
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Grove Wellness, LLC | Clinical | Current | Accepting new patients |
| Riverside Community Care, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Flat Rock, IN
- NPI 1104565605
-
- Community/Behavioral Health Agency
- Norwood, MA
- NPI 1780791467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1255733689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 WESTERN BLVD STE E",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461429217",
"telephone_number": "317-426-1847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 WESTERN BLVD STE E",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461429217",
"telephone_number": "317-426-1847"
}
],
"practiceLocations": [
{
"address_1": "111 South St",
"address_purpose": "LOCATION",
"city": "Somerville",
"state": "MA",
"postal_code": "021434297",
"country_code": "US",
"telephone_number": "617-354-2275",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "JESSICA",
"middle_name": "VAN NESS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-17",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34008517A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "VAN NESS",
"middle_name": "MORGAN",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.