Jeanelle Lynn Verwayne, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004866A Issued in IN

Practice address

3171 N Meridian St
Indianapolis, IN 46208-4784

Phone

(317) 941-5010

Fax

(317) 931-5140

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Cummins Behavioral Health Systems, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Avon, IN
  • NPI 1740232115
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1891811576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7904 WINDHAM LAKE WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462141441",
            "telephone_number": "317-941-5010",
            "fax_number": "317-931-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3171 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084784",
            "telephone_number": "317-941-5010",
            "fax_number": "317-931-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERWAYNE",
        "first_name": "JEANELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004866A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000529855",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Versiti Blood Health Inc. (Indiana Blood Center)
• Jennifer Vertrees, OT
• Verve Health LLC
• Verve Health LLC
• Sonya Vervoorn
• Breea Vest, OTR, OTD
• George Lungren Vestermark, MD
• Karrie Veteto, BCBA
• Vetra Davis
• Dessie M Vetter, NP

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.