NPIMap

Individual provider Active NPI

Jacquelyn Jane Hexham, MSW, LLMSW, CAAC

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1386809234
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801089160 Issued in MI
Practice address
945 E 8TH St
Suite a
Traverse City, MI 49686-2895
Phone
(231) 933-0500
Fax
(231) 943-5105
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801089160 MI Primary

Addresses

Primary practice location

945 E 8TH St
Suite a
Traverse City, MI 49686-2895

Mailing address

945 E 8TH St
Suite a
Traverse City, MI 49686-2895
Phone (231) 933-0500

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

State licenses

LicenseStateTypeSpecialty
6801089160MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nexus Family Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1386809234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 E 8TH ST",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862895",
            "telephone_number": "231-933-0500",
            "fax_number": "231-943-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 E 8TH ST",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862895",
            "telephone_number": "231-933-0500",
            "fax_number": "231-943-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEXHAM",
        "first_name": "JACQUELYN",
        "middle_name": "JANE",
        "credential": "MSW, LLMSW, CAAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.