Ann Louise Jardine, CLINICAL SOCIAL WORK

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017441 Issued in PA

Practice address

10 Ice Lake Dr
Mountain Top, PA 18707-9652

Phone

(440) 823-1235

NPI assigned

Sep 20, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1326826272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ICE LAKE DR",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187079652",
            "telephone_number": "440-823-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ICE LAKE DR",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187079652",
            "telephone_number": "440-823-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "ANN",
        "middle_name": "LOUISE",
        "credential": "CLINICAL SOCIAL WORK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0700159",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keefer Hoover
• Micahel John Humen, ATC, MED
• Bryanna Hurn, FNP-C
• Independent Life Home Care & Staffing Solutions LLC
• Irene Lucas M.D.
• Nancy Jeffery, OTR/L
• Maureen Ann Jesikiewicz, RPH
• John a Hosage DDS
• James Joseph Johns DDS Jr., DDS
• Kevin W Jones, RPH

• Clinical Social Worker in Mountain Top, PA
• Providers in Mountain Top, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.