Individual provider Active NPI

Jennifer Dale Occhipinti, LCSW, LCDC

  • Clinical Social Worker
  • Granbury, TX
National Provider Identifier
1588493936
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
69404 Issued in TX
Practice address
1201 W 2ND St Ste 105
Granbury, TX 76048-1490
Phone
(817) 330-4898
Fax
(844) 999-1487
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15960 TX
Social Worker 104100000X 69404 TX
Clinical Social Worker 1041C0700X 69404 TX Primary

Addresses

Primary practice location

1201 W 2ND St Ste 105
Granbury, TX 76048-1490

Mailing address

1030 E Hwy 377 Ste 110
PMB 412
Granbury, TX 76048-1244
Phone (817) 330-4898

Other practice location 1

624 Oldham Ln
Granbury, TX 76048-6278
Phone (817) 559-4694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20250709000077 TX Practitioner - Clinical Social Worker 9234643677 Practice locations: Granbury, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1201 W 2ND St
Suite 105
Granbury, TX 76048-1490
Phone (817) 330-4898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15960TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1588493936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E HWY 377 STE 110",
            "address_2": "PMB 412",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481244",
            "telephone_number": "817-330-4898",
            "fax_number": "844-999-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 2ND ST STE 105",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481490",
            "telephone_number": "817-330-4898",
            "fax_number": "844-999-1487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Oldham Ln",
            "address_purpose": "LOCATION",
            "city": "Granbury",
            "state": "TX",
            "postal_code": "760486278",
            "country_code": "US",
            "telephone_number": "817-559-4694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCCHIPINTI",
        "first_name": "JENNIFER",
        "middle_name": "DALE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15960",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "69404",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "69404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.