Individual provider Active NPI

Jessica Anne Neely, MSW, LCSW

  • Social Worker
  • Brownsburg, IN
National Provider Identifier
1760439301
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33005002A Issued in IN
Practice address
1103 E Main St
Brownsburg, IN 46112
Phone
(317) 852-6603
Fax
(317) 350-2939
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 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 33005002A IN Primary

Addresses

Primary practice location

1103 E Main St
Brownsburg, IN 46112

Mailing address

1103 E Main St
Brownsburg, IN 46112-1431
Phone (317) 852-6603

Other practice location 1

2345 S Lynhurst Dr
Ste 205
Indianapolis, IN 46241-8630
Phone (317) 247-8900 ext. 210

Other identifiers 1

IdentifierTypeStateIssuer
F1632OtherINOUTPATIENT THERAPY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33005002AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Voyage Counseling LLC PastSince Jun 27, 2021 Accepting new patients
Cummins Behavioral Health Systems, Incorporated Past Accepting new patients

Organizations & group practices 2

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1760439301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 E MAIN ST",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121431",
            "telephone_number": "317-852-6603",
            "fax_number": "317-350-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 E MAIN ST",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "46112",
            "telephone_number": "317-852-6603",
            "fax_number": "317-350-2939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2345 S Lynhurst Dr",
            "address_2": "Ste 205",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462418630",
            "country_code": "US",
            "telephone_number": "317-247-8900 x210",
            "fax_number": "317-247-8935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEELY",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33005002A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT THERAPY",
            "identifier": "F1632",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.