Andrea Jenkins, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006421A Issued in IN

Practice address

4024 Ashbourne LN
Indianapolis, IN 46226-3019

Phone

(317) 796-2622

NPI assigned

Oct 9, 2009

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)

Not 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 and National Provider Directory roles.

• Children'S Therapy Connection, Inc.

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1366609166
  NPD (past)

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1467787366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 ASHBOURNE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462263019",
            "telephone_number": "317-281-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 ASHBOURNE LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462263019",
            "telephone_number": "317-796-2622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7209 N Shadeland Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502021",
            "country_code": "US",
            "telephone_number": "317-288-7606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33005529A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006421A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobbie N Jellison, MD
• Shelby Jellison, RBT
• Geneva Lorraine Jemison
• Jenesis Gentle Care LLC
• Ginnie Jeng
• Gregory T Jenkins, M.D.
• Hannah Nicole Jenkins, PHARMD
• Jacqueline M Jenkins, OD
• Jordan Brian Jenkins
• Joslyn Ann Jenkins

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.