Individual provider Active NPI

Jessica Madeline Barnes

  • Clinical Social Worker
  • Gastonia, NC
National Provider Identifier
1881148039
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C014120 Issued in NC
Practice address
175 W Franklin Blvd
Gastonia, NC 28052-4145
Phone
(704) 865-3525
NPI assigned
Aug 4, 2016
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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
Clinical Social Worker 1041C0700X C014120 NC Primary

Addresses

Primary practice location

175 W Franklin Blvd
Gastonia, NC 28052-4145

Mailing address

175 W Franklin Blvd
Gastonia, NC 28052-4145

Other practice location 1

708 S Chestnut St
Gastonia, NC 28054-4548
Phone (704) 865-3525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210813003224 NC Practitioner - Clinical Social Worker 9436553393 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Robinson Rd
Suite D
Gastonia, NC 28056-8851
Phone (704) 691-9415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C014120NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Release Counseling Center PLLC Clinical CurrentSince Jun 1, 2024 Accepting new patients
Support Incorporated Clinical CurrentSince Aug 19, 2021 Accepting new patients
Shelby Wellness & Therapy Center PLLC CurrentSince Jul 23, 2021 Accepting new patients
Support Incorporated Clinical Past Accepting new patients

Locations

175 W Franklin Blvd
Gastonia, NC 28052
Phone (704) 865-3529

708 S Chestnut St
Gastonia, NC 28054
Phone (704) 854-4840

800 Robinson Rd
Ste D
Gastonia, NC 28056
Phone (704) 691-9415

809 N Lafayette St
Ste A
Shelby, NC 28150
Phone (704) 284-0554

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1881148039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W FRANKLIN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W FRANKLIN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524145",
            "telephone_number": "704-865-3525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 S Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280544548",
            "country_code": "US",
            "telephone_number": "704-865-3525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "JESSICA",
        "middle_name": "MADELINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.