Active NPI
Phyllis Ann Jeannestal, LCSW
- Clinical Social Worker
- Tamarac, FL
National Provider Identifier
1801259106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 9302 NW 66TH CT
Tamarac, FL 33321-3506 - Phone
- (954) 393-4385
- NPI assigned
- Apr 4, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
9302 NW 66TH CT
Tamarac, FL 33321-3506
Mailing address
9302 NW 66TH CT
Tamarac, FL 33321-3506
Phone (954) 393-4385
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jafco | Past | Accepting new patients | |
| Jewish Adoption and Foster Care Options,Inc | 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.
-
- Foster Care Agency
- Sunrise, FL
- NPI 1083943237
-
- Community/Behavioral Health Agency
- Sunrise, FL
- NPI 1356400790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1801259106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9302 NW 66TH CT",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333213506",
"telephone_number": "954-393-4385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9302 NW 66TH CT",
"city": "TAMARAC",
"state": "FL",
"postal_code": "333213506",
"telephone_number": "954-393-4385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEANNESTAL",
"first_name": "PHYLLIS",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-04",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tamarac, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.