Individual provider Active NPI

Jennifer Wheeler, MSW, LCSW, QMHP

  • Clinical Social Worker
  • Klamath Falls, OR
National Provider Identifier
1801257548
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10538 Issued in OR
Practice address
905 Main St Ste 200B
Klamath Falls, OR 97601-6066
Phone
(541) 887-0751
NPI assigned
Mar 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X L10538 OR Primary

Addresses

Primary practice location

905 Main St Ste 200B
Klamath Falls, OR 97601-6066

Mailing address

905 Main St Ste 200B
Klamath Falls, OR 97601-6066
Phone (541) 887-0751

Other practice location 1

2210 N Eldorado Ave
Klamath Falls, OR 97601-6418
Phone (541) 883-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20210617002507 OR Practitioner - Clinical Social Worker 6608276225 Reassigns benefits to 1 organization
Practice locations: Klamath Falls, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Minds LLCGroup PAC ID 8325490675, 3 clinicians

Practice addresses (Care Compare)

905 Main St
Suite 200B
Klamath Falls, OR 97601-6066
Phone (541) 887-0751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10538ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Minds LLC Mental Health CurrentSince Nov 28, 2023 Accepting new patients

Locations

905 Main St
Ste 200B
Klamath Falls, OR 97601
Phone (541) 887-0751

Organizations & group practices 1

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1801257548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MAIN ST STE 200B",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016066",
            "telephone_number": "541-887-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MAIN ST STE 200B",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016066",
            "telephone_number": "541-887-0751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 N Eldorado Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976016418",
            "country_code": "US",
            "telephone_number": "541-883-1030",
            "fax_number": "541-884-2338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JENNIFER",
        "credential": "MSW, LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.