Jerissa Owens, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851115722 Issued in MI

Practice address

1 Parklane Blvd Ste 200E
Dearborn, MI 48126-2400

Phone

(313) 846-2606

NPI assigned

May 31, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Psygenics Inc

  • Clinical Social Worker
  • Dearborn, MI
  • NPI 1669736104
  NPD

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1548953128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 ROCK WAY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106508",
            "telephone_number": "517-580-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARKLANE BLVD STE 200E",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262400",
            "telephone_number": "313-846-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "JERISSA",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851115722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Ouza
• Haidar Ouza
• Alice Ovlasuk
• Ibtisam Owaid
• Anais Owens
• Nneka Jean Owens, MA LPC NCC
• Phyllis Owens
• Ibukunoluwa Azeezat Oyeneyin
• Similoluwa J Oyinkolade
• Jessica A Oz

• Clinical Social Worker in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.