Individual provider Active NPI

Tenisha Lashay Fennie

  • Counselor
  • East Chicago, IN
National Provider Identifier
1508900176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
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

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260122003794 IN Practitioner - Clinical Social Worker 7810474699 Reassigns benefits to 1 organization

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

OrganizationSpecialtyStatusNew patients
Supportive Social Work Services LLC CurrentSince Sep 8, 2025 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.

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

Verify at the official NPI Registry.