Jestine Devarge Jennings, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086992 Issued in NY

Practice address

384 E 149TH St
Bronx, NY 10455-3908

Phone

(631) 983-7298

NPI assigned

Apr 25, 2019

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 11, 2019 through Jul 11, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1356905301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 YATES ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117041922",
            "telephone_number": "631-983-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553908",
            "telephone_number": "631-983-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JESTINE",
        "middle_name": "DEVARGE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Powell Therapies Licensed Behavior Analyst P.C.
• Jennifer R. Simmons, PT, PC
• Jennifer Reyna
• Annie R Jennings, LCSW
• Charles Leonard Jennings, LMSW CASAC
• Marilena A. Jennings, M.D.
• Marissa Anne Jennings, PA-C
• Marvin Eevan Jennings, D.P.M.
• Sarah C Jennings, NP
• Elizabeth Jenny-Avital

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.