Individual provider Active NPI

Jacqueline Lee Whalen, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1871961441
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13770 Issued in MD
Practice address
315 W Patrick St
Frederick, MD 21701-4855
Phone
(301) 228-2303
Fax
(301) 228-2731
NPI assigned
Sep 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13770 MD Primary

Addresses

Primary practice location

315 W Patrick St
Frederick, MD 21701-4855

Mailing address

315 W Patrick St
Frederick, MD 21701-4855
Phone (301) 228-2303

Other practice location 1

13215 Brook Lane
Hagerstown, MD 21742-4855
Phone (301) 733-0330

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

NPI Registry JSON

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

{
    "created_epoch": "1442016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1871961441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014855",
            "telephone_number": "301-228-2303",
            "fax_number": "301-228-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014855",
            "telephone_number": "301-228-2303",
            "fax_number": "301-228-2731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13215 Brook Lane",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217424855",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-12",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.