Jenna Wills, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

350 Center Rock GRN Ste 9
Oxford, CT 06478-3170

Phone

(203) 951-1858

Fax

(203) 307-1771

NPI assigned

Dec 31, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Southern Connecticut Christian Counseling CenterGroup PAC ID 9133266109, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southern Connecticut Christian Counseling Center

  • Community/Behavioral Health Agency
  • Fairfield, CT
  • NPI 1164652871

  Clinical

  Medicare reassignment Care Compare group NPD
• Wellness Center of Oxford

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelton, CT
  • NPI 1275008195

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1942897350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TOPPENFJEL LN",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781537",
            "telephone_number": "203-627-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CENTER ROCK GRN STE 9",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064783170",
            "telephone_number": "203-951-1858",
            "fax_number": "203-307-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "JENNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Oxford, CT
• Providers in Oxford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.