Individual provider Active NPI

Jenna Alexa Abrams, LCSW, LICSW

  • Clinical Social Worker
  • Dupont, WA
National Provider Identifier
1710595301
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015378 Issued in NC
Practice address
1485 Bobs Hollow LN
Dupont, WA 98327-9744
Phone
(253) 234-4648
NPI assigned
Jul 20, 2020
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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 LW61482652 WA
Clinical Social Worker 1041C0700X C015378 NC Primary

Addresses

Primary practice location

1485 Bobs Hollow LN
Dupont, WA 98327-9744

Mailing address

1485 Bobs Hollow LN
Dupont, WA 98327-9744
Phone (203) 253-3204

Other practice location 1

920 Cambridge St
Fayetteville, NC 28303-5300
Phone (910) 663-4014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C015378NCMDClinical Social Worker
LW61482652WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Psychotherapy & Counseling Services PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1710595301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 BOBS HOLLOW LN",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279744",
            "telephone_number": "203-253-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 BOBS HOLLOW LN",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279744",
            "telephone_number": "253-234-4648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283035300",
            "country_code": "US",
            "telephone_number": "910-663-4014",
            "fax_number": "910-493-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "JENNA",
        "middle_name": "ALEXA",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61482652",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dupont, WA

Sources for this page

Verify at the official NPI Registry.