Active NPI
Jennifer Denofa, MSW
- Methadone Clinic
- Wilkes-Barre, PA
National Provider Identifier
1366648792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- Practice address
- Rear 307 Laird St.
Wilkes-Barre, PA 18702 - Phone
- (570) 408-9320
- Fax
- (570) 408-9324
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | Primary |
Addresses
Primary practice location
Rear 307 Laird St.
Wilkes-Barre, PA 18702
Mailing address
51 Holiday Dr., Apt. 109
Kingston, PA 18704
Phone (610) 703-0152
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1366648792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 HOLIDAY DR., APT. 109",
"city": "KINGSTON",
"state": "PA",
"postal_code": "18704",
"telephone_number": "610-703-0152",
"fax_number": "570-408-9324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "REAR 307 LAIRD ST.",
"city": "WILKES-BARRE",
"state": "PA",
"postal_code": "18702",
"telephone_number": "570-408-9320",
"fax_number": "570-408-9324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENOFA",
"first_name": "JENNIFER",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes-Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.