Active NPI
Jennifer Etchison Klingler, LCSW-C
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1942561345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12185
- Practice address
- 600 Wyndhurst Ave
Suite 245E
Baltimore, MD 21210-2489 - Phone
- (443) 682-7780
- Fax
- (443) 682-7781
- NPI assigned
- Jun 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12185 | MD | Primary |
Addresses
Primary practice location
600 Wyndhurst Ave
Suite 245E
Baltimore, MD 21210-2489
Mailing address
600 Wyndhurst Ave
Suite 245E
Baltimore, MD 21210-2489
Phone (443) 682-7780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 29, 2023 through Dec 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12185 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338508800000",
"number": "1942561345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 WYNDHURST AVE",
"address_2": "SUITE 245E",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212102489",
"telephone_number": "443-682-7780",
"fax_number": "443-682-7781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WYNDHURST AVE",
"address_2": "SUITE 245E",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212102489",
"telephone_number": "443-682-7780",
"fax_number": "443-682-7781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINGLER",
"first_name": "JENNIFER",
"middle_name": "ETCHISON",
"name_prefix": "Ms.",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-01",
"last_updated": "2012-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "12185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.