Individual provider Active NPI

Penny Elaine Jansen, L.M.S.W.

  • Clinical Social Worker
  • Hillsdale, MI
National Provider Identifier
1922122845
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085407 Issued in MI
Practice address
1360 S Hillsdale Rd
Hillsdale, MI 49242-9367
Phone
(517) 425-4975
NPI assigned
Mar 17, 2007
Last updated
Jan 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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 6801085407 MI Primary

Addresses

Primary practice location

1360 S Hillsdale Rd
Hillsdale, MI 49242-9367

Mailing address

1360 S Hillsdale Rd
Hillsdale, MI 49242-9367
Phone (517) 425-4975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070424000324 MI Practitioner - Clinical Social Worker 2365547197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson-Hillsdale Community Mental Health BoardGroup PAC ID 6406808062, 27 clinicians

Practice addresses (Care Compare)

3200 W Carleton Rd
Hillsdale, MI 49242-9458
Phone (517) 437-0117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson-Hillsdale Community Mental Health Board CurrentSince Oct 1, 2024 Accepting new patients
Segue Inc CurrentSince Jan 9, 2017 Accepting new patients
Jackson-Hillsdale Community Mental Health Board CurrentSince Oct 1, 2024 Accepting new patients
New Hope, LLC Clinical Past Accepting new patients
Consumer Services, Inc. Past Accepting new patients

Locations

1360 S Hillsdale Rd
Hillsdale, MI 49242
Phone (517) 439-4228

3200 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-0114

1200 N West Ave
Jackson, MI 49202
Phone (517) 789-1200

Organizations & group practices 5

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": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1922122845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 S HILLSDALE RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429367",
            "telephone_number": "517-425-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S HILLSDALE RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429367",
            "telephone_number": "517-425-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "PENNY",
        "middle_name": "ELAINE",
        "credential": "L.M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-17",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.