Individual provider Active NPI

Rachel Jenkins

  • Clinical Social Worker
  • Allison Park, PA
National Provider Identifier
1467975144
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW020274 Issued in PA
Practice address
4068 Mount Royal Blvd Ste 119
Allison Park, PA 15101-2951
Phone
(412) 228-0385
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 CW020274 PA Primary

Addresses

Primary practice location

4068 Mount Royal Blvd Ste 119
Allison Park, PA 15101-2951

Mailing address

4068 Mount Royal Blvd Ste 119
Allison Park, PA 15101-2951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2022 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW020274PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holding Space Therapy Services LLC Clinical CurrentSince Mar 24, 2024 Accepting new patients

Locations

4068 Mount Royal Blvd
Ste 119
Allison Park, PA 15101
Phone (412) 228-0385

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1467975144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4068 MOUNT ROYAL BLVD STE 119",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151012951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4068 MOUNT ROYAL BLVD STE 119",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151012951",
            "telephone_number": "412-228-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allison Park, PA

Sources for this page

Verify at the official NPI Registry.