Individual provider Active NPI

Jennifer Rose Vandeweg, LMSW

  • School Social Worker
  • Hereford, AZ
National Provider Identifier
1417201708
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
18450 Issued in MD
Practice address
5770 E Hoot Owl Holw
Hereford, AZ 85615-9623
Phone
(706) 836-8373
NPI assigned
Nov 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 18450 MD Primary

Addresses

Primary practice location

5770 E Hoot Owl Holw
Hereford, AZ 85615-9623

Mailing address

5770 E Hoot Owl Holw
Hereford, AZ 85615-9623
Phone (706) 836-8373

Other practice location 1

200 Booth St
Elkton, MD 21921-5657
Phone (410) 996-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013002362 AZ Practitioner - Clinical Social Worker 8224525456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Help and Hope Counseling, LLC 2 clinicians

Practice addresses (Care Compare)

100 S 7TH St
Suite 2And3
Sierra Vista, AZ 85635-2509
Phone (602) 435-4356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18450MDMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC CurrentSince Sep 1, 2025 Accepting new patients
Help and Hope Counseling, LLC CurrentSince Dec 31, 2025 Accepting new patients

Locations

4111 E Valley Auto Dr
Ste 106
Mesa, AZ 85206
Phone (602) 341-3495

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

100 S 7th St
Ste 23
Sierra Vista, AZ 85635
Phone (602) 435-4356

1200 N El Dorado Pl
Ste 640
Tucson, AZ 85715
Phone (520) 298-9746

Organizations & group practices 2

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": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417201708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 E HOOT OWL HOLW",
            "city": "HEREFORD",
            "state": "AZ",
            "postal_code": "856159623",
            "telephone_number": "706-836-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 E HOOT OWL HOLW",
            "city": "HEREFORD",
            "state": "AZ",
            "postal_code": "856159623",
            "telephone_number": "706-836-8373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Booth St",
            "address_purpose": "LOCATION",
            "city": "Elkton",
            "state": "MD",
            "postal_code": "219215657",
            "country_code": "US",
            "telephone_number": "410-996-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEWEG",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2025-09-11",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MD",
            "license": "18450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hereford, AZ

Sources for this page

Verify at the official NPI Registry.