Individual provider Active NPI

Jennifer Spitz, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1619680162
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW024585 Issued in PA
Practice address
135 W Durham St
Philadelphia, PA 19119
Phone
(856) 827-3396
NPI assigned
Dec 29, 2022
Last updated
Jan 21, 2025By the provider in NPPES
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW024585 PA Primary

Addresses

Primary practice location

135 W Durham St
Philadelphia, PA 19119

Mailing address

4522 Baltimore Ave
Philadelphia, PA 19143-3705
Phone (215) 278-9234

Other practice location 1

515 Woodland Ter
Philadelphia, PA 19104-5181
Phone (215) 360-1277

Other names 1

  • Jenna Spitz Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jenna@mendingspacephl.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW024585PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1619680162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 BALTIMORE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191433705",
            "telephone_number": "215-278-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W DURHAM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19119",
            "telephone_number": "856-827-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Woodland Ter",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191045181",
            "country_code": "US",
            "telephone_number": "215-360-1277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPITZ",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2022-12-29",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenna@mendingspacephl.com",
            "affiliation": "N",
            "endpointDescription": "Practice Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4522 Baltimore Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191433705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "SPITZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.