Active NPI
Jennifer Shavonne Coughlin, MSW, LSW
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1477789899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SL05324100
- Practice address
- 7727 Dorcas St
Philadelphia, PA 19111-2824 - Phone
- (215) 806-1995
- Fax
- (215) 437-7520
- NPI assigned
- Jun 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SL05324100 | NJ | Primary |
Addresses
Primary practice location
7727 Dorcas St
Philadelphia, PA 19111-2824
Mailing address
7727 Dorcas St
Philadelphia, PA 19111-2824
Phone (215) 806-1995
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05324100 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243814400000",
"number": "1477789899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7727 DORCAS ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112824",
"telephone_number": "215-806-1995",
"fax_number": "215-437-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7727 DORCAS ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112824",
"telephone_number": "215-806-1995",
"fax_number": "215-437-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUGHLIN",
"first_name": "JENNIFER",
"middle_name": "SHAVONNE",
"name_prefix": "Mrs.",
"credential": "MSW, LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-01",
"last_updated": "2009-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SL05324100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.