Bessie Elizabeth Tadlock-Jimenez, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00943450 Issued in WV

Practice address

1021 Quarrier St
Suite 414
Charleston, WV 25301-2338

Phone

(304) 340-3676

Fax

(304) 340-3688

NPI assigned

Jul 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD
• Family Counseling Connection

  • Community/Behavioral Health Agency
  • Charleston, WV
  • NPI 1659594638
  NPD (past)
• Family Counseling Connections

  • Mental Health Counselor
  • Charleston, WV
  • NPI 1548519887
  NPD (past)
• Kanawha Pastoral Counseling Center

  • Counselor
  • Charleston, WV
  • NPI 1891826707

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1558702878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 QUARRIER ST",
            "address_2": "SUITE 414",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012338",
            "telephone_number": "304-340-3676",
            "fax_number": "304-340-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 QUARRIER ST",
            "address_2": "SUITE 414",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012338",
            "telephone_number": "304-340-3676",
            "fax_number": "304-340-3688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TADLOCK-JIMENEZ",
        "first_name": "BESSIE",
        "middle_name": "ELIZABETH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "BP00943450",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00943450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00943450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023815000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btadlockjimenez198712@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kamryn Tabor
• Cindy Sue Tack
• Brittany Leigh Tackett, CRNA
• Tara L. Tackett, APRN-CNP
• Roxanne Tacy
• Dany Tager, M.D
• Melanie Bagshaw Takubo, PA-C
• Leslie Ann Talbert
• Heather Talerico
• Ester Bernice Tallarico, FNP-BC

• Clinical Social Worker in Charleston, WV
• Providers in Charleston, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.