Jennifer Amendolari Brown, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004168 Issued in GA

Practice address

2565 Thompson Bridge Rd Ste 111
Gainesville, GA 30501-1723

Phone

(917) 494-1410

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Federation Employment and Guidance Service, Inc

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1942243084
  NPD (past)
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1760422166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 THOMPSON BRIDGE RD STE 111",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011723",
            "telephone_number": "917-494-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 THOMPSON BRIDGE RD STE 111",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011723",
            "telephone_number": "917-494-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Green St NW",
            "address_2": "2ND FLOOR",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013313",
            "country_code": "US",
            "telephone_number": "917-494-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JENNIFER",
        "middle_name": "AMENDOLARI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO59786",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Mitchell Brown, M.D.
• Emma Brown, PA
• Grace M Walker Brown, RN, FNP-BC
• Gregory Brown, RN
• Jane H Brown
• Joshua Dylan Brown, DPT
• Justin Ralph Brown, PA-C
• Margaret Larae Brown, SLP
• Mary Jane Brown, NP-C
• Matthew Brown, M.S. CCS-SLP

• Clinical Social Worker in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.