Individual provider Active NPI

Jennis Lynn Scott, LSW, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Cincinnati, OH
National Provider Identifier
1669029872
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
120683 Issued in OH
Practice address
44 E Crescentville Rd
Cincinnati, OH 45246-1302
Phone
(513) 671-7117
Fax
(513) 671-7110
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.2208102 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 120683 OH Primary

Addresses

Primary practice location

44 E Crescentville Rd
Cincinnati, OH 45246-1302

Mailing address

42 East Crescentville Rd
Cincinnati, OH 45246-1302
Phone (513) 671-7117

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
120683OHMDAddiction (Substance Use Disorder) Counselor
S.2208102OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Care of Ohio, LLC Addiction (Substance Use Disorder) CurrentSince Dec 28, 2022 Accepting new patients
Premier Care of Ohio LLC Addiction (Substance Use Disorder) PastSince Aug 25, 2019 Accepting new patients

Locations

44 E Crescentville Rd
West Chester, OH 45246
Phone (513) 671-7117

Organizations & group practices 2

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1669029872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 EAST CRESCENTVILLE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452461302",
            "telephone_number": "513-671-7117",
            "fax_number": "513-671-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E CRESCENTVILLE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452461302",
            "telephone_number": "513-671-7117",
            "fax_number": "513-671-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "JENNIS",
        "middle_name": "LYNN",
        "credential": "LSW, CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2208102",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "120683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.