Individual provider Active NPI

Lindsay Jenniges, LICSW

  • Clinical Social Worker
  • Worthington, MN
National Provider Identifier
1275864019
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18079 Issued in MN
Practice address
1211 Clary St
Worthington, MN 56187-2005
Phone
(507) 376-6121
Fax
(507) 372-4304
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18079 MN Primary

Addresses

Primary practice location

1211 Clary St
Worthington, MN 56187-2005

Mailing address

1211 Clary St
Worthington, MN 56187-2005
Phone (507) 376-6121

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

State licenses

LicenseStateTypeSpecialty
18079MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Mental Health Center Inc PastSince Aug 15, 2016 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1275864019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 CLARY ST",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872005",
            "telephone_number": "507-376-6121",
            "fax_number": "507-372-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 CLARY ST",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872005",
            "telephone_number": "507-376-6121",
            "fax_number": "507-372-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNIGES",
        "first_name": "LINDSAY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.