Individual provider Active NPI

Ericka Jobe, PHD, LSCSW, LCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1912410671
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06396 Issued in KS
Practice address
10100 W Maple St Ste 102
Wichita, KS 67209-3148
Phone
(316) 295-3495
NPI assigned
Nov 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 21204 OK
Clinical Social Worker 1041C0700X 06396 KS Primary

Addresses

Primary practice location

10100 W Maple St Ste 102
Wichita, KS 67209-3148

Mailing address

10100 W Maple St Ste 102
Wichita, KS 67209-3148
Phone (316) 295-3495

Other names 1

  • Ericka Bruechert Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
06396KSMDClinical Social Worker
21204OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jobe Family Behavioral Health Services, LLC Clinical Current Accepting new patients
Outbloom Therapy Services LLC Clinical Current Accepting new patients
Outbloom Therapy Services LLC Clinical Current Accepting new patients

Locations

10100 W Maple St
Ste 102
Wichita, KS 67209
Phone (316) 295-3495

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1912410671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 W MAPLE ST STE 102",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672093148",
            "telephone_number": "316-295-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 W MAPLE ST STE 102",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672093148",
            "telephone_number": "316-295-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBE",
        "first_name": "ERICKA",
        "name_prefix": "Dr.",
        "credential": "PHD, LSCSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "21204",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "06396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICKA",
            "last_name": "BRUECHERT",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.