NPIMap

Individual provider Active NPI

Chad Jensen, LMSW, IADC

  • Clinical Social Worker
  • Carroll, IA
National Provider Identifier
1902270390
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
01611 Issued in IA
Practice address
23751 Highway 30
Carroll, IA 51401-8505
Phone
(712) 792-9266
NPI assigned
Nov 23, 2015
Last updated
Nov 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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 01611 IA Primary

Addresses

Primary practice location

23751 Highway 30
Carroll, IA 51401-8505

Mailing address

23751 Highway 30
P.O. Box 427
Carroll, IA 51401-8505
Phone (712) 792-9266

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)
Not enrolled

Organizations & group practices 3

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": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1902270390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23751 HIGHWAY 30",
            "address_2": "P.O. BOX 427",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514018505",
            "telephone_number": "712-792-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23751 HIGHWAY 30",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514018505",
            "telephone_number": "712-792-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CHAD",
        "credential": "LMSW, IADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.