Individual provider Active NPI

Jacqueline Anne Hornickell, MSW, LSW

  • Social Worker
  • Lebanon, PA
National Provider Identifier
1730647561
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW135776 Issued in PA
Practice address
15 S 9TH St
Lebanon, PA 17042-5104
Phone
(717) 273-5992
Fax
(717) 273-5995
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW135776 PA Primary

Addresses

Primary practice location

15 S 9TH St
Lebanon, PA 17042-5104

Mailing address

410 N Prince St
Lancaster, PA 17603-3010
Phone (717) 560-7917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20260416001018 PA Practitioner - Clinical Social Worker 9739655820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW135776PAMDSocial Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1730647561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033010",
            "telephone_number": "717-560-7917",
            "fax_number": "717-560-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S 9TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425104",
            "telephone_number": "717-273-5992",
            "fax_number": "717-273-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNICKELL",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW135776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.