Individual provider Active NPI

Jennifer Audette Henningfield, LCSW

  • Clinical Social Worker
  • Valencia, CA
National Provider Identifier
1528540465
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L14213 Issued in OR
Practice address
28494 Westinghouse PL Ste 213
Valencia, CA 91355-0934
Phone
(661) 259-8200
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS16000 CA
Clinical Social Worker 1041C0700X L14213 OR Primary

Addresses

Primary practice location

28494 Westinghouse PL Ste 213
Valencia, CA 91355-0934

Mailing address

25663 Estoril St
Valencia, CA 91355-2545
Phone (661) 259-4655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240402001499 OR Practitioner - Clinical Social Worker 1850739459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2725 SW Cedar Hills Blvd
Suite 250
Beaverton, OR 97005-1344
Phone (503) 415-4060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS16000CAMDClinical Social Worker
L14213ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Mar 19, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Mar 19, 2024 Accepting new patients

Locations

2725 SW Cedar Hills Blvd
Ste 250
Beaverton, OR 97005
Phone (503) 413-4060

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

Organizations & group practices 2

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1528540465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25663 ESTORIL ST",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552545",
            "telephone_number": "661-259-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28494 WESTINGHOUSE PL STE 213",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913550934",
            "telephone_number": "661-259-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGFIELD",
        "first_name": "JENNIFER",
        "middle_name": "AUDETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L14213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.