NPIMap

Individual provider Active NPI

Jean Lebron Audain, LICSW, LCSW-C

  • Clinical Social Worker
  • Laurel, MD
National Provider Identifier
1861869927
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16948 Issued in MD
Practice address
8713 Granite LN
Laurel, MD 20708-2435
Phone
(410) 961-0120
NPI assigned
Aug 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16948 MD Primary
Clinical Social Worker 1041C0700X LC50080459 DC

Addresses

Primary practice location

8713 Granite LN
Laurel, MD 20708-2435

Mailing address

8713 Granite LN
Laurel, MD 20708-2435
Phone (410) 961-0120

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

State licenses

LicenseStateTypeSpecialty
LC50080459DCMDClinical Social Worker
16948MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jean L Audain LLC Clinical CurrentSince May 16, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1861869927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 GRANITE LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082435",
            "telephone_number": "410-961-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 GRANITE LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082435",
            "telephone_number": "410-961-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDAIN",
        "first_name": "JEAN",
        "middle_name": "LEBRON",
        "name_prefix": "Mr.",
        "credential": "LICSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16948",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080459",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.