Jessica Agudelo Benito, DSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2018003790 Issued in MO

Practice address

435 Nichols Rd Ste 200
Kansas City, MO 64112-2036

Phone

(816) 368-2000

NPI assigned

Jul 20, 2014

Last updated

Jan 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Social Worker

Education

State University of New York at Stony Brook, School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Luminaries Project LLC

  dba The Center for Healing and Recovery

  • Professional Counselor
  • Kansas City, MO
  • NPI 1992058184

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1821405036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 901348",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641901348",
            "telephone_number": "816-535-0975",
            "fax_number": "816-298-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NICHOLS RD STE 200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641122036",
            "telephone_number": "816-368-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 NW Briarcliff Pkwy Fl 2",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641161878",
            "country_code": "US",
            "telephone_number": "816-368-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7280 NW 87th Ter Ste C210",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641533720",
            "country_code": "US",
            "telephone_number": "816-368-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENITO",
        "first_name": "JESSICA",
        "middle_name": "AGUDELO",
        "name_prefix": "Dr.",
        "credential": "DSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-20",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092290",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2018003790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Nicole Bengtson, COTA/L
• Benilde Hall Program
• Benilde Hall Program
• Benilde Hall Program
• Bryant Michael Benitez, RN
• Victoria Benjamin, PHARM D
• Carmen Rene Benn, LMSW
• Lancelot Benn, MD
• Karen Benner
• Kathy Yvonne Bennett Bowie, PSY.D

• Clinical Social Worker in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.