Active NPI
Jenelle Slobof, LICSW/LCSW-BACS
- Social Worker
- Saint Paul, MN
National Provider Identifier
1811083439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11655
- Practice address
- 1016 James CT
Saint Paul, MN 55118-3640 - Phone
- (561) 308-5904
- NPI assigned
- Oct 4, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11655 | MN | Primary |
| Clinical Social Worker | 1041C0700X | SW7155 | FL | |
| Clinical Social Worker | 1041C0700X | 11928 | LA |
Addresses
Primary practice location
1016 James CT
Saint Paul, MN 55118-3640
Mailing address
1016 James CT
Saint Paul, MN 55118-3640
Phone (561) 308-5904
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 975724400 | Medicaid | MN | |
| 152298 | Other | MN | BEHAVIORAL HEALTHCARE |
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 |
|---|---|---|---|
| SW7155 | FL | MD | Clinical Social Worker |
| 11928 | LA | MD | Clinical Social Worker |
| 11655 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hennepin County | Clinical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Hennepin County Mental Health Center
- Psychiatry Physician
- Minneapolis, MN
- NPI 1780790345
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361232000000",
"number": "1811083439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 JAMES CT",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551183640",
"telephone_number": "561-308-5904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 JAMES CT",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551183640",
"telephone_number": "561-308-5904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLOBOF",
"first_name": "JENELLE",
"credential": "LICSW/LCSW-BACS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2013-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "11655",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW7155",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "11928",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "975724400",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIORAL HEALTHCARE",
"identifier": "152298",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.