Jaclyn Danielle Callender

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801111287 Issued in MI

Practice address

1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365

Phone

(989) 269-9293

NPI assigned

Jun 10, 2019

Last updated

Sep 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaclyn Danielle Roggenbuck Former name

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1376102723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 R DALE WERTZ DR",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131365",
            "telephone_number": "989-269-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 R DALE WERTZ DR",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131365",
            "telephone_number": "989-269-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLENDER",
        "first_name": "JACLYN",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801111287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "ROGGENBUCK",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katrina A Brock, LMSW
• Diane Brown
• Jessica A Brown
• Kaitlin Brown
• Alicia M Burkhard
• Caring for Others, Inc
• Colette Susanne Carlsen, RN
• David Leon Carter, MD
• Shannon Carter
• Ashley Case, RN

• Clinical Social Worker in Bad Axe, MI
• Providers in Bad Axe, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.