Jennifer Elaine Wentworth, MA LMFT

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

10501 Creek Street SE
Ste 2
Yelm, WA 98597

Phone

(360) 960-0441

NPI assigned

Nov 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Wentworth MFT PLLC

  • Mental Health Counselor
  • Yelm, WA
  • NPI 1518674993
  Medicare reassignment NPD Authorized official
• Bina Souri MD PS

  • Obstetrics & Gynecology Physician
  • Olympia, WA
  • NPI 1962750588
  NPD (past)

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1669759155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 CREEK STREET SE",
            "address_2": "STE 2",
            "city": "YELM",
            "state": "WA",
            "postal_code": "98597",
            "telephone_number": "360-960-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 CREEK STREET SE",
            "address_2": "STE 2",
            "city": "YELM",
            "state": "WA",
            "postal_code": "98597",
            "telephone_number": "360-960-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MA LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61054557",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Ward, LMP
• Waterfalls Longevity Center PLLC
• Amanda Weaber
• Wendy D. Johnson Arnp LLC
• Wentworth MFT PLLC
• Karen Whitaker
• Cynthia Anne Wilson, DO
• Rebekah J. Wilson, R.N.
• Denise S Wood
• Mackenzie Elizabeth Wood, DMD

• Counselor in Yelm, WA
• Providers in Yelm, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.