Individual provider Active NPI

Jocelyn Hope Wender-Shubow

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1477003929
Registry record updated Oct 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024877 Issued in MA
Practice address
170 Morton St
Jamaica Plain, MA 02130-3735
Phone
(617) 971-3273
NPI assigned
Oct 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2016

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 1024877 MA Primary

Addresses

Primary practice location

170 Morton St
Jamaica Plain, MA 02130-3735

Mailing address

36 Southbourne Rd
Jamaica Plain, MA 02130-4633
Phone (617) 272-5340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1024877MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1475884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475884800000",
    "number": "1477003929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SOUTHBOURNE RD",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304633",
            "telephone_number": "617-272-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-971-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDER-SHUBOW",
        "first_name": "JOCELYN",
        "middle_name": "HOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-08",
        "last_updated": "2016-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2016; 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.