Active NPI
Jessie Klein
- Social Worker
- Clarksville, MD
National Provider Identifier
1497402994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 6100 Daylong LN Ste 103
Clarksville, MD 21029-1631 - Phone
- (410) 531-8100
- NPI assigned
- Mar 4, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
6100 Daylong LN Ste 103
Clarksville, MD 21029-1631
Mailing address
6100 Daylong LN Ste 103
Clarksville, MD 21029-1631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28891 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646352000000",
"number": "1497402994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6100 DAYLONG LN STE 103",
"city": "CLARKSVILLE",
"state": "MD",
"postal_code": "210291631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6100 DAYLONG LN STE 103",
"city": "CLARKSVILLE",
"state": "MD",
"postal_code": "210291631",
"telephone_number": "410-531-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "JESSIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-04",
"last_updated": "2022-03-04",
"certification_date": "2022-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.