Jennifer Jean Barry, LCSW, CCM

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

67264 Issued in TX

Practice address

777 Lake Carolyn Pkwy Apt 4103
Irving, TX 75039-4514

Phone

(443) 226-7338

NPI assigned

Dec 4, 2020

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1366048415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 LAKE CAROLYN PKWY APT 4103",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394514",
            "telephone_number": "443-226-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 LAKE CAROLYN PKWY APT 4103",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394514",
            "telephone_number": "443-226-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "JENNIFER",
        "middle_name": "JEAN",
        "credential": "LCSW, CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": "4214625",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dhyeya Barot, DPT
• Dipa Deep Barot, MD
• Rachel H Barr, LCSW
• Berenice Barraza
• Alison Barrera, MS, CCC-SLP
• Jo Ellen Bartholomew, LMFT
• Samata Basani, M.D
• Renuka Vijay Basavaraju, M.D.
• Margaret Bascom, LPC-ASSOCIATE
• Jennifer Min-Wen Yin Bashour, M.D.

• Clinical Social Worker in Irving, TX
• Providers in Irving, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.