Stephen Jarrell, LCSW, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34001650A Issued in IN

Practice address

2712 S Calhoun St
Fort Wayne, IN 46807-1402

Phone

(260) 744-4326

Fax

(260) 744-0188

NPI assigned

Jan 31, 2007

Last updated

Sep 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family & Childrens Service of Fort Wayne Inc

  • Community/Behavioral Health Agency
  • Fort Wayne, IN
  • NPI 1699820720
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1528105202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071402",
            "telephone_number": "260-744-4326",
            "fax_number": "260-744-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071402",
            "telephone_number": "260-744-4326",
            "fax_number": "260-744-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "STEPHEN",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000362A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001650A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200090360A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jade Januseski, M.A., CCC-SLP
• Jessica H Jarboe, D.D.S.
• Donna Grace Sabarillo Jardiolin, P.T
• Jarice Helping Hand LLC
• Jarpole Enterprises LLC (Fort Wayne Recovery Center)
• Teresa A. Jarrell, LCAC
• Rachel Jarvis
• Rachel Jarvis
• Kori Jasper, BS
• Jaspreet S Jawanda, M.D.

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.