Individual provider Active NPI

Jennifer Sullivan Price, LCSW

  • Clinical Social Worker
  • Seymour Johnson AFB, NC
National Provider Identifier
1396006722
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
COO7720 Issued in NC
Practice address
2803 Medical Campus Drive
Seymour Johnson AFB, NC 27531
Phone
(984) 277-7882
NPI assigned
Jun 1, 2012
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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 COO7720 NC Primary

Addresses

Primary practice location

2803 Medical Campus Drive
Seymour Johnson AFB, NC 27531

Mailing address

208 Malloy St
Unit E
Goldsboro, NC 27534-4478
Phone (919) 778-5594

Other practice location 1

208 Malloy St
Unit E
Goldsboro, NC 27534-4478
Phone (919) 778-5594

Other identifiers 1

IdentifierTypeStateIssuer
6009108MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1396006722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MALLOY ST",
            "address_2": "UNIT E",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344478",
            "telephone_number": "919-778-5594",
            "fax_number": "919-778-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 MEDICAL CAMPUS DRIVE",
            "city": "SEYMOUR JOHNSON AFB",
            "state": "NC",
            "postal_code": "27531",
            "telephone_number": "984-277-7882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Malloy St",
            "address_2": "Unit E",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275344478",
            "country_code": "US",
            "telephone_number": "919-778-5594",
            "fax_number": "919-778-5633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JENNIFER",
        "middle_name": "SULLIVAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "COO7720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6009108",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour Johnson AFB, NC

Sources for this page

Verify at the official NPI Registry.