Individual provider Active NPI

Jennifer M Goodwin

  • Social Worker
  • Atlantic City, NJ
National Provider Identifier
1679059125
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SC05996700 Issued in NJ
Practice address
13 N Hartford Ave
Atlantic City, NJ 08401-3512
Phone
(609) 348-1161
Fax
(609) 645-7343
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X 44SC05996700 NJ Primary

Addresses

Primary practice location

13 N Hartford Ave
Atlantic City, NJ 08401-3512

Mailing address

6550 Delilah Rd Ste 301
Egg Harbor Township, NJ 08234-5102
Phone (609) 272-8580

Other names 1

  • Jennifer Jobes Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05996700NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1679059125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 DELILAH RD STE 301",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345102",
            "telephone_number": "609-272-8580",
            "fax_number": "609-645-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 N HARTFORD AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084013512",
            "telephone_number": "609-348-1161",
            "fax_number": "609-645-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC05996700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOBES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlantic City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.