A. Douglas Jennette, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-000051 Issued in NC

Practice address

4816 Six Forks Rd Ste 104
Raleigh, NC 27609-5250

Phone

(919) 781-6393

Fax

(919) 781-1589

NPI assigned

Jan 1, 2007

Sex

Male

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)

Enrolled

State licenses

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1568529626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 SIX FORKS RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095250",
            "telephone_number": "919-781-6393",
            "fax_number": "919-781-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 SIX FORKS RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095250",
            "telephone_number": "919-781-6393",
            "fax_number": "919-781-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNETTE",
        "first_name": "A.",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C-000051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharrah Ericka Jenkins, M.D.
• Tammy Jenkins
• Teresa Stringe Jenkins
• Camille Loye Jenkinson, PA-C
• Meghan Jenks, DC
• Candace Charlisa Jennette, MASTER'S EDUCATION
• Tara Jennette
• Jennifer C. Matthews, DDS , PA
• Jennifer L. H. Murphy, O.D., P.a.
• Jennifer Q Le DMD PA

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.