Individual provider Active NPI

Dawn S Jennings

  • Addiction (Substance Use Disorder) Counselor
  • South Bend, IN
National Provider Identifier
1790698009
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
99135492A Issued in IN
Practice address
2420 Viridian Dr
South Bend, IN 46628-4396
Phone
(574) 314-0492
NPI assigned
Sep 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33013228A
Addiction (Substance Use Disorder) Counselor 101YA0400X 99135492A IN Primary

Addresses

Primary practice location

2420 Viridian Dr
South Bend, IN 46628-4396

Mailing address

806 Obrien St
South Bend, IN 46628-2518
Phone (574) 314-0492

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1790698009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 OBRIEN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466282518",
            "telephone_number": "574-314-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 VIRIDIAN DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466284396",
            "telephone_number": "574-314-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "DAWN",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-26",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "33013228A",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "99135492A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.