Active NPI
Jessica N Carter, ACSW
- Clinical Social Worker
- Sonora, CA
National Provider Identifier
1871083196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW81400
- Practice address
- 230 S Shepherd St Ste D
Sonora, CA 95370-5076 - Phone
- (209) 454-5904
- NPI assigned
- May 11, 2018
- Last updated
- Dec 7, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 81400 | CA | |
| Clinical Social Worker | 1041C0700X | ASW81400 | CA | Primary |
Addresses
Primary practice location
230 S Shepherd St Ste D
Sonora, CA 95370-5076
Mailing address
230 S Shepherd St Ste D
Sonora, CA 95370-5076
Phone (209) 454-5904
Other practice location 1
105 Hospital Rd
Sonora, CA 95370-5227
Phone (209) 533-6245
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
| License | State | Type | Specialty |
|---|---|---|---|
| 81400 | CA | MD | Counselor |
| ASW81400 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Tuolumne | Past | Accepting new patients | |
| County of Tuolumne | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tuolumne County Behavioral Health
- Community/Behavioral Health Agency
- Sonora, CA
- NPI 1366618035
-
- Community/Behavioral Health Agency
- Sonora, CA
- NPI 1417502188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575676800000",
"number": "1871083196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 S SHEPHERD ST STE D",
"city": "SONORA",
"state": "CA",
"postal_code": "953705076",
"telephone_number": "209-454-5904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 S SHEPHERD ST STE D",
"city": "SONORA",
"state": "CA",
"postal_code": "953705076",
"telephone_number": "209-454-5904"
}
],
"practiceLocations": [
{
"address_1": "105 Hospital Rd",
"address_purpose": "LOCATION",
"city": "Sonora",
"state": "CA",
"postal_code": "953705227",
"country_code": "US",
"telephone_number": "209-533-6245",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARTER",
"first_name": "JESSICA",
"middle_name": "N",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-11",
"last_updated": "2019-12-07",
"certification_date": "2019-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "81400",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW81400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.