Lisa K Jennings, PHD, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50932 Issued in TX

Practice address

6475 E Pacific Coast Hwy # 369
Long Beach, CA 90803-4201

Phone

(512) 496-9978

NPI assigned

Jul 14, 2022

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1669106696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 E PACIFIC COAST HWY # 369",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034201",
            "telephone_number": "512-496-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 E PACIFIC COAST HWY # 369",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034201",
            "telephone_number": "512-496-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "LISA",
        "middle_name": "K",
        "credential": "PHD, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Alden Jenkins, PH.D.
• Tre Jenkins
• Connelly Anne Jenks, LCSW
• Andrew Allen Jennings
• Lauren Jennings, M.ED.
• Maureen Jennings, PT
• Michael W. Jennings
• Shantell M Jennings
• Asanti Jensen
• Heather Strohmeyer Jensen, PHD

• Clinical Social Worker in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.