Jessica McKinnie, LCSW-C, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15636 Issued in MD

Practice address

10111 Martin Luther King Jr Hwy Ste 118
Bowie, MD 20720-4226

Phone

(301) 200-1885

NPI assigned

Mar 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life & Peace Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bowie, MD
  • NPI 1740915958

  DC, Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1316442619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7006 PALAMAR TER",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062151",
            "telephone_number": "301-257-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 MARTIN LUTHER KING JR HWY STE 118",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204226",
            "telephone_number": "301-200-1885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Olney Sandy Spring Rd Ste 340",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "MD",
            "postal_code": "208323306",
            "country_code": "US",
            "telephone_number": "301-570-7500",
            "fax_number": "301-570-7504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNIE",
        "first_name": "JESSICA",
        "credential": "LCSW-C, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McGovern Physical Therapy and Performance LLC (Bowie Physical Therapy Associates)
• Kevin Michael McGovern, PT
• Mary K. McIndoe, LPC, LCPC
• Hope McKenzie
• Colette McKie
• Alanna McKiver
• Burnus Duvale McKnight
• Poonam McKnight, LCPC
• James McLaurin
• Jeannette Michelle McNeill, LCSW-C

• Clinical Social Worker in Bowie, MD
• Providers in Bowie, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.

Verify at the official NPI Registry.