Individual provider Active NPI

Jennifer P Packer, MSW, LICSW

  • Clinical Social Worker
  • Bessemer, AL
National Provider Identifier
1902207533
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1820 3Rd Ave N
Bessemer, AL 35020
Phone
(205) 586-5644
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 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 Primary

Addresses

Primary practice location

1820 3Rd Ave N
Bessemer, AL 35020

Mailing address

7628 Georgia Ave
Leeds, AL 35094-7216
Phone (205) 586-5644

Other practice location 1

7628 Georgia Ave
Leeds, AL 35094-7216
Phone (205) 586-5644

Other practice location 2

3007 Caroline St
Houston, TX 77004-2822
Phone (713) 528-2328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220809001686 GA Practitioner - Clinical Social Worker 7911129226 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Aug 4, 2022 Accepting new patients

Locations

3348 Peachtree Rd NE
Ste 700
Atlanta, GA 30326
Phone (720) 712-7900

Interoperability endpoints

  • Direct secure messaging: jenniferpacker@tdh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1902207533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7628 GEORGIA AVE",
            "city": "LEEDS",
            "state": "AL",
            "postal_code": "350947216",
            "telephone_number": "205-586-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 3RD AVE N",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "35020",
            "telephone_number": "205-586-5644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7628 Georgia Ave",
            "address_purpose": "LOCATION",
            "city": "Leeds",
            "state": "AL",
            "postal_code": "350947216",
            "country_code": "US",
            "telephone_number": "205-586-5644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3007 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770042822",
            "country_code": "US",
            "telephone_number": "713-528-2328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKER",
        "first_name": "JENNIFER",
        "middle_name": "P",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bessemer, AL

Sources for this page

Verify at the official NPI Registry.