Active NPI
Jessica Anne Neely, MSW, LCSW
- Social Worker
- Brownsburg, IN
National Provider Identifier
1760439301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 33005002A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F1632 | Other | IN | OUTPATIENT 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
| License | State | Type | Specialty |
|---|---|---|---|
| 33005002A | IN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Voyage Counseling LLC | Past | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Avon, IN
- NPI 1740232115
-
- Community/Behavioral Health Agency
- Brownsburg, IN
- NPI 1619547452
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.