Jenny Mae Kirwin, LCSW, LCAS, CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

880 Issued in NC

Practice address

9339 Cub Run Dr
Concord, NC 28027-5404

Phone

(803) 627-2401

NPI assigned

Sep 16, 2006

Last updated

Dec 17, 2015By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Familiy Works Inc.

  • Mental Health Counselor
  • Gastonia, NC
  • NPI 1811006778
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1396841433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9339 CUB RUN DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280275404",
            "telephone_number": "803-627-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9339 CUB RUN DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280275404",
            "telephone_number": "803-627-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWIN",
        "first_name": "JENNY",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LCAS, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "880",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003793",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002794",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kingdom Connections, Inc.
• Robert Bruce Kinney Jr., M.D.
• James Frederick Kirk, M.D.
• Natalie G Kirkman
• Kendall Kirsteier
• Kish Patel, DDS, PA
• Lourine Kissi
• Klear Vision Incorporated (BrightStar of Cabarrus/Stanly)
• David Fremd Klein, M.D.
• Kylie Alexis Klein, RN

• Addiction (Substance Use Disorder) Counselor in Concord, NC
• Providers in Concord, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.