Active NPI
Jessica Mahaney
- Clinical Social Worker
- Bowling Green, KY
National Provider Identifier
1306491576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 254321
- Practice address
- 1830 Destiny LN Ste 112
Bowling Green, KY 42104-1089 - Phone
- (270) 792-0400
- NPI assigned
- Aug 5, 2019
- Last updated
- Aug 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 254321 | KY | Primary |
Addresses
Primary practice location
1830 Destiny LN Ste 112
Bowling Green, KY 42104-1089
Mailing address
755 Leayou Rd
Alvaton, KY 42122-9634
Phone (270) 792-0400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200325000710 | KY | Practitioner - Clinical Social Worker | 0648608679 | Practice locations: Bowling Green, KY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1830 Destiny LN
Suite 112
Bowling Green, KY 42104-1089
Phone (270) 792-0400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 254321 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1306491576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 LEAYOU RD",
"city": "ALVATON",
"state": "KY",
"postal_code": "421229634",
"telephone_number": "270-792-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 DESTINY LN STE 112",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421041089",
"telephone_number": "270-792-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHANEY",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "254321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, KY
- Husam Eldin Maglad, M.D.
- Paul Elkin Maglinger, M.D.
- Magna Chiro Med, LLC
- Magna Chiropractic Spine Center of Bowling Green
- Magnolia Village Health Center LLC (Magnolia Village)
- Sandra T Mahoney, LCSW
- Maria Eve Main, A.R.N.P
- Haroon Mustafa Majoka, M.D
- Malchow & Lawless Orthodontics PSC
- Glenn Ray Malchow, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.