Active NPI
Jennifer Ann Ross, MSW, LICSW
- Clinical Social Worker
- Everett, WA
National Provider Identifier
1528574928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60676374
- Practice address
- 1700 13TH St
Everett, WA 98201-1689 - Phone
- (425) 404-4347
- Fax
- (425) 404-4347
- NPI assigned
- Dec 20, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60676374 | WA | Primary |
Addresses
Primary practice location
1700 13TH St
Everett, WA 98201-1689
Mailing address
16412 Andal Rd
Mount Vernon, WA 98274-7102
Phone (360) 610-1227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241114004705 | WA | Practitioner - Clinical Social Worker | 5991139172 | Practice locations: Mount Vernon, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
404 S 1St St
Suite 200B
Mount Vernon, WA 98273-3866
Phone (436) 424-0400
406 S 1St St
Suite 308
Mount Vernon, WA 98273-3897
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60676374 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513728000000",
"number": "1528574928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16412 ANDAL RD",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982747102",
"telephone_number": "360-610-1227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 13TH ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011689",
"telephone_number": "425-404-4347",
"fax_number": "425-404-4347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "JENNIFER",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-20",
"last_updated": "2017-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60676374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.