Jennifer Baker Sheridan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7894 Issued in MS

Practice address

615 W Pine St
Hattiesburg, MS 39401-3835

Phone

(601) 795-1564

NPI assigned

Sep 25, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Restoration House Counseling

  • Mental Health Counselor
  • Hattiesburg, MS
  • NPI 1497331508

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1962019745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DOGWOOD CIR",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394654142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W PINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013835",
            "telephone_number": "601-795-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "JENNIFER",
        "middle_name": "BAKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan P Shappley, M.D.
• Manika Sharma, MD
• Stephanie Lauren Shelby, CFY-SLP
• Susan Mullen Shemper, DNP, BSN, RN
• Meghann C Sheppeard, MSN, FNP, B.C.
• Richard Sheridan
• Randall L Sherman, MD
• Lauren Kelli Shoemake, MSW, LCSW
• Jonathan W Shook, MD
• Adrian Cromer Shuler

• Clinical Social Worker in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.