Active NPI
Jennifer Childerson, MSW
- Social Worker
- East Saint Louis, IL
National Provider Identifier
1326448952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 5601 State St
East Saint Louis, IL 62203-1346 - Phone
- (618) 213-3170
- Fax
- (618) 213-3171
- NPI assigned
- Sep 2, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
5601 State St
East Saint Louis, IL 62203-1346
Mailing address
5601 State St
East Saint Louis, IL 62203-1346
Phone (618) 213-3170
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoyleton Youth and Family Services | Past | 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.
-
- Foster Care Agency
- East Saint Louis, IL
- NPI 1932484748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409616000000",
"number": "1326448952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 STATE ST",
"city": "EAST SAINT LOUIS",
"state": "IL",
"postal_code": "622031346",
"telephone_number": "618-213-3170",
"fax_number": "618-213-3171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 STATE ST",
"city": "EAST SAINT LOUIS",
"state": "IL",
"postal_code": "622031346",
"telephone_number": "618-213-3170",
"fax_number": "618-213-3171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDERSON",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-02",
"last_updated": "2014-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Saint Louis, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.