Dana Dayle Jessup, LSCSW
Individual provider Active NPI Clinical Social Worker · MC Louth, KS
NPI 1508890146 · NPPES record last updated Feb 14, 2017
Key facts
- NPI
- 1508890146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 3142 (KS)
- Practice address
- 17821 78TH St
MC Louth, KS 66054-5091 - Phone
- (785) 742-7113
- Fax
- (785) 742-3085
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Access Behavioral Health Services
Practice addresses (Care Compare)
1276 W River St
Suite 100
Boise, ID 83702-7083
Phone (208) 338-4699
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS, ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041202000315 | KS | Practitioner - Clinical Social Worker | 9830155811 | Practice locations: MC Louth, KS |
| I20230227000856 | ID | Practitioner - Clinical Social Worker | 9830155811 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3711 | KS | MD | Professional Counselor |
| 3142 | KS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Behavioral Health Services | Current |
Accepting new patients | |
| Access Behavioral Health Services, Inc | Current |
Accepting new patients | |
| Kanza Mental Health and Guidance Center, Inc. | Past | Accepting new patients | |
| John T Bopp PC | Clinical | Past | Accepting new patients |
Locations
1276 W River St
Ste 100
Boise, ID 83702
Phone (208) 338-4699
3307 Caldwell Blvd
Ste 104
Nampa, ID 83651
Phone (208) 465-4833
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | KS | ||
| Clinical Social Worker | 1041C0700X | 3142 | KS | Yes |
Addresses
Primary practice location
17821 78TH St
MC Louth, KS 66054-5091
Mailing address
17821 78TH St
MC Louth, KS 66054-5091
Phone (785) 742-7113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100097950B | Medicaid | KS | |
| 100097950A | Medicaid | KS |
Other providers in MC Louth, KS
- Pamela Leigh Carleton
- Genesis Danielle Claypool
- Danielle Lee Hermann
- Nancy Ann Hermreck
- Lawrence Memorial Hospital
- Lawrence Physicians LLC
- McLouth Medical Clinic
- Carrie Lynn Miller
- Melissa Norris
All providers in MC Louth, KS · Clinical Social Worker in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.