Jennifer Jereckos, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851105154 Issued in MI

Practice address

340 N Main St Ste 200
Plymouth, MI 48170-1250

Phone

(734) 335-0028

NPI assigned

Dec 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

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.

• Simply Mindful Counseling, LLC

  • Clinical Social Worker
  • Plymouth, MI
  • NPI 1851900302
  Medicare reassignment NPD

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1760140677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CLAIR ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431707",
            "telephone_number": "586-565-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MAIN ST STE 200",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701250",
            "telephone_number": "734-335-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Clair St",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480431707",
            "country_code": "US",
            "telephone_number": "586-565-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERECKOS",
        "first_name": "JENNIFER",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851105154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayana Jenkins Muhammad
• Jacquana Jenkins
• Jennifer Gauvin LLC
• Jennifer Seim-Andrew Licensed Professional Counselor LLC
• Jennifer Tremonti PLLC
• Kelly Christine Jew-Garcia, PA-C
• Naman Jhaveri, MD
• Michael Jimenez
• Jira Indiana LLC
• Jocelyn a. Markowicz PH.D, P.C.

• Clinical Social Worker in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.