Active NPI
Tenisha Lashay Fennie
- Counselor
- East Chicago, IN
National Provider Identifier
1508900176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3903 Indianapolis Blvd
East Chicago, IN 46312-2555 - Phone
- (219) 398-7050
- Fax
- (219) 757-1950
- NPI assigned
- Feb 16, 2007
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
3903 Indianapolis Blvd
East Chicago, IN 46312-2555
Mailing address
904 E Becker St
Hammond, IN 46320-2109
Phone (219) 677-3169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1440 W Taylor St
Chicago, IL 60607-4623
3709 Broadway
Suite 27
Gary, IN 46409-1501
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Social Work Services LLC | Current | Accepting new patients |
Locations
9501 Indianapolis Blvd
Ste 1A
Highland, IN 46322
Phone (219) 368-1545
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.
-
- Adult Mental Health Clinic/Center
- Highland, IN
- NPI 1003797119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508900176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 E BECKER ST",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463202109",
"telephone_number": "219-677-3169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3903 INDIANAPOLIS BLVD",
"city": "EAST CHICAGO",
"state": "IN",
"postal_code": "463122555",
"telephone_number": "219-398-7050",
"fax_number": "219-757-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNIE",
"first_name": "TENISHA",
"middle_name": "LASHAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Chicago, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.