Individual provider Active NPI

Jennifer Jelenic, LCSW

  • Clinical Social Worker
  • Manitowoc, WI
National Provider Identifier
1285234393
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
131924 Issued in WI
Practice address
2719 Calumet Ave
Manitowoc, WI 54220-5546
Phone
(920) 686-2333
Fax
(920) 686-2334
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 131924 WI Primary

Addresses

Primary practice location

2719 Calumet Ave
Manitowoc, WI 54220-5546

Mailing address

PO Box 959
Sheboygan, WI 53082-0959
Phone (920) 783-6633

Other names 1

  • Jennifer L Moliter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251106000524 WI Practitioner - Clinical Social Worker 4082104245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 655
Kenosha, WI 53141

PO Box
Suite 959
Sheboygan, WI 53082-0959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131924WIMDClinical Social Worker
11447WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Community Health Care, Inc Current Accepting new patients
Lakeshore Community Health Care, Inc CurrentSince Sep 19, 2025 Accepting new patients
Lakeshore Community Health Care, Inc CurrentSince Sep 19, 2025 Accepting new patients

Locations

2719 Calumet Ave
Manitowoc, WI 54220
Phone (920) 686-2333

Organizations & group practices 3

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": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1285234393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530820959",
            "telephone_number": "920-783-6633",
            "fax_number": "920-783-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 CALUMET AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205546",
            "telephone_number": "920-686-2333",
            "fax_number": "920-686-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELENIC",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "131924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MOLITER",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.