Jeri Lynne Peckens, B.S.

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

12200 E 13 Mile Rd
Warren, MI 48093-3093

Phone

(248) 554-6356

Fax

(248) 554-6498

NPI assigned

Sep 22, 2020

Sex

Female

Sole proprietor

No

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

Credentials

Bachelor of Science

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1568078756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CLOVERPORT AVE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072709",
            "telephone_number": "248-652-6957",
            "fax_number": "248-554-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933093",
            "telephone_number": "248-554-6356",
            "fax_number": "248-554-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKENS",
        "first_name": "JERI",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Warren, MI
• Providers in Warren, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.