Jeannette Theresa Arias-Flynn, MS

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LPC 787-125 Issued in WI

Practice address

100 County Rd B
Behavioral Health Shawano
Shawano, WI 54166-7072

Phone

(920) 720-2300

Fax

(920) 720-3806

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

• Ms. 'Jay' T Arias-Flynn Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 18, 2010.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1831279694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-720-3700",
            "fax_number": "920-720-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY RD B",
            "address_2": "BEHAVIORAL HEALTH SHAWANO",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "920-720-2300",
            "fax_number": "920-720-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIAS-FLYNN",
        "first_name": "JEANNETTE",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "787125",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "787-125",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "LPC 787-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "(CAQH)",
            "identifier": "11737276",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39596000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11737276",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "'JAY'",
            "last_name": "ARIAS-FLYNN",
            "middle_name": "T",
            "prefix": "MS.",
            "credential": "MS, LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Shawano, WI
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.