Jaclyn Danielle Callender
Individual provider Active NPI Clinical Social Worker · Bad Axe, MI
NPI 1376102723 · NPPES record last updated Sep 23, 2021
Key facts
- NPI
- 1376102723
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801111287 (MI)
- Practice address
- 1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365 - Phone
- (989) 269-9293
- NPI assigned
- Jun 10, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801111287 | MI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801111287 | MI | Yes |
Addresses
Primary practice location
1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365
Mailing address
1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365
Phone (989) 269-9293
Other names
- Jaclyn Danielle Roggenbuck
Other providers in Bad Axe, MI
- Diane Brown
- Jessica A Brown
- Kaitlin Brown
- Alicia M Burkhard
- Jeana M Burkhard
- Caring for Others, Inc
- Colette Susanne Carlsen
- David Leon Carter
- Shannon Carter
- Ashley Case
All providers in Bad Axe, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.