Jennie Chavis, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06279900 Issued in NJ

Practice address

1250 Sussex Tpke Ste N
Randolph, NJ 07869-2908

Phone

(973) 532-2256

NPI assigned

Nov 9, 2022

Sex

Female

Sole proprietor

No

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.

• New Jersey Center for Cognitive and Dialectical Behavior Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Randolph, NJ
  • NPI 1518516061
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 1, 2023.

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1548978331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "MOUNT FREEDOM",
            "state": "NJ",
            "postal_code": "079700645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 SUSSEX TPKE STE N",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692908",
            "telephone_number": "973-532-2256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Maple Ave Apt 1E",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079605296",
            "country_code": "US",
            "telephone_number": "973-532-2256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "JENNIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06279900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Carbone, PT
• Gabriella Cassie, BCBA
• Laura Castro, DMD
• Peter James Cetta, MD
• Charmoy Dental Associates
• Michelle Hsien Yun Chen, PHD
• Aleda Straley Cheng, DVM
• Violetta Chyc-Olesiak, DPT
• Marisa Ciufalo, M.D.
• Thomas Roger Coleman, EDD

• All providers in Randolph, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.