Individual provider Active NPI

Jasmine Wynn, LCSW

  • Clinical Social Worker
  • Newark, DE
National Provider Identifier
1639588353
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0001441 Issued in DE
Practice address
256 Chapman Rd Ste 201
Newark, DE 19702-5415
Phone
(302) 292-1334
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 090156-1 NY
Social Worker 104100000X 090156-1 NY
Clinical Social Worker 1041C0700X Q1-0001441 DE Primary

Addresses

Primary practice location

256 Chapman Rd Ste 201
Newark, DE 19702-5415

Mailing address

256 Chapman Rd Ste 201
Newark, DE 19702-5415
Phone (302) 292-1334

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
090156-1NYMDSocial Worker
Q1-0001441DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Child Development, Incorporated Clinical CurrentSince Apr 17, 2020 Accepting new patients

Locations

256 Chapman Rd
Ste 201
Newark, DE 19702
Phone 3022921334 ext. 710

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1639588353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 CHAPMAN RD STE 201",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025415",
            "telephone_number": "302-292-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 CHAPMAN RD STE 201",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025415",
            "telephone_number": "302-292-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "JASMINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "090156-1",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090156-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.