Individual provider Active NPI

Jenece Marie Jacobs-Sharkey, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1649854043
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
42749 Issued in MT
Practice address
500 W Broadway St FL 4
Missoula, MT 59802-4008
Phone
(406) 327-1900
Fax
(406) 327-1974
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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 42749 MT Primary

Addresses

Primary practice location

500 W Broadway St FL 4
Missoula, MT 59802-4008

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (406) 327-1900

Other practice location 1

2901 Queen St
Missoula, MT 59801-8652
Phone (406) 552-5749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20210521001249 MT Practitioner - Clinical Social Worker 7911306014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
FL 4
Missoula, MT 59802-4008
Phone (406) 327-1940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42749MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince May 24, 2021 Accepting new patients
Providence Health & Services Mt Clinical CurrentSince May 24, 2021 Accepting new patients
Providence Health & Services Mt Current Accepting new patients

Locations

500 W Broadway St
Fl 4
Missoula, MT 59802
Phone (406) 327-1900

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1649854043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "406-327-1900",
            "fax_number": "406-327-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST FL 4",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-327-1900",
            "fax_number": "406-327-1974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Queen St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598018652",
            "country_code": "US",
            "telephone_number": "406-552-5749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS-SHARKEY",
        "first_name": "JENECE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "42749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.