Active NPI
Jessica Kingsley, LCSW
- Clinical Social Worker
- Nashville, TN
National Provider Identifier
1740906841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6357
- Practice address
- 7729 Daniel Trce
Nashville, TN 37221-6509 - Phone
- (615) 828-0305
- NPI assigned
- Oct 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C012574 | NC | |
| Clinical Social Worker | 1041C0700X | 34008158A | IN | |
| Clinical Social Worker | 1041C0700X | 17814 | AZ | |
| Clinical Social Worker | 1041C0700X | 6357 | TN | Primary |
Addresses
Primary practice location
7729 Daniel Trce
Nashville, TN 37221-6509
Mailing address
7729 Daniel Trce
Nashville, TN 37221-6509
Phone (615) 828-0305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
333 N Alabama St
Suite 350
Indianapolis, IN 46204-2275
Phone (866) 630-0966
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6357 | TN | MD | Professional Counselor |
| 17814 | AZ | MD | Clinical Social Worker |
| 34008158A | IN | MD | Clinical Social Worker |
| C012574 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
Locations
20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113
333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002
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": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1740906841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7729 DANIEL TRCE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372216509",
"telephone_number": "615-828-0305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7729 DANIEL TRCE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372216509",
"telephone_number": "615-828-0305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGSLEY",
"first_name": "JESSICA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-19",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C012574",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34008158A",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "17814",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "6357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.