Jillian L Tebbe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008502A Issued in IN

Practice address

390 Erie Ave
Connersville, IN 47331-3177

Phone

(765) 825-4124

Fax

(765) 825-3649

NPI assigned

Nov 8, 2011

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 names 1

• Jillian L Evans Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1902183718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 ERIE AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473313177",
            "telephone_number": "765-825-4124",
            "fax_number": "765-825-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 ERIE AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473313177",
            "telephone_number": "765-825-4124",
            "fax_number": "765-825-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBBE",
        "first_name": "JILLIAN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008502A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "EVANS",
            "middle_name": "L",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pauline Stanton, LCSW
• Allison Struewing, PHARMD
• Mark Edward Sullenbarger, PTA
• Suresh M Patel MD PMC
• John U. Tan, MD
• Renee Anne Telker, RN
• Clay Tenbarge, DC
• The Eye Center Group LLC
• Dashell Lynn Tout
• Andy Tran, MD

• Clinical Social Worker in Connersville, IN
• Providers in Connersville, 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 Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.