Individual provider Active NPI

Jessica E Bennett, LMSW

  • Clinical Social Worker
  • Ludington, MI
National Provider Identifier
1306184684
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092385 Issued in MI
Practice address
920 Diana St
Ludington, MI 49431-1987
Phone
(231) 845-6294
Fax
(231) 845-7095
NPI assigned
Jan 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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 6801092385 MI Primary

Addresses

Primary practice location

920 Diana St
Ludington, MI 49431-1987

Mailing address

920 Diana St
Ludington, MI 49431-1987
Phone (231) 845-6294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130213000499 MI Practitioner - Clinical Social Worker 7618121948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1675 E Mt Garfield Rd
Suite 125a
Muskegon, MI 49444-7732
Phone (231) 670-7416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Muskegon CurrentSince Aug 31, 2019 Accepting new patients
Great Lakes Hope LLC Clinical CurrentSince Jan 1, 2021 Accepting new patients
County of Muskegon CurrentSince Aug 31, 2019 Accepting new patients

Locations

1675 E Mount Garfield Rd
Ste 125A
Muskegon, MI 49444
Phone (616) 344-4785

376 E Apple Ave
Muskegon, MI 49442
Phone (231) 724-3699

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": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1306184684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DIANA ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311987",
            "telephone_number": "231-845-6294",
            "fax_number": "231-845-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DIANA ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311987",
            "telephone_number": "231-845-6294",
            "fax_number": "231-845-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JESSICA",
        "middle_name": "E",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.