Jennifer Minnicks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005559 Issued in GA

Practice address

13 W Park SQ NE Ste D
Marietta, GA 30060-2294

Phone

(912) 690-4911

NPI assigned

Jul 27, 2015

Sex

Female

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)

Not 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 and National Provider Directory roles.

• Marietta Counseling Practice

  • Clinical Social Worker
  • Marietta, GA
  • NPI 1952866006
  NPD Authorized official

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1639554058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 W PARK SQ NE STE D",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602294",
            "telephone_number": "912-690-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 W PARK SQ NE STE D",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602294",
            "telephone_number": "912-690-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICKS",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-27",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Health Solutions Ga PC
• Mindful Solutions Therapy
• Mindful Transitions, LLC
• Lydia Emmons Minear, MA, LAPC
• Bailey Mingledorff
• Kathleen Jamila Minnifield
• Yolande M. Minor, ED.D.
• Mintysmile Dentistry
• Kathleen Miraflores, O.D.
• Karla Vanessa Miralles, DNP, APRN

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.