Individual provider Active NPI

Jennifer Lynn Carpenter, LMSW

  • Social Worker
  • Adrian, MI
National Provider Identifier
1962748418
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801095104 Issued in MI
Practice address
1040 S Winter St
Suite 1022
Adrian, MI 49221-3867
Phone
(517) 263-8905
Fax
(517) 265-8237
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801095104 MI Primary

Addresses

Primary practice location

1040 S Winter St
Suite 1022
Adrian, MI 49221-3867

Mailing address

1040 S Winter St
Suite 1022
Adrian, MI 49221-3867
Phone (517) 263-8905

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
I20211005001624 MI Practitioner - Clinical Social Worker 8628476694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801095104MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lenawee Community Mental Health Authority CurrentSince Sep 29, 2021 Accepting new patients
Lenawee Community Mental Health Authority PastSince Sep 29, 2021 Accepting new patients

Locations

1040 S Winter St
Ste 1022
Adrian, MI 49221
Phone (517) 263-8905

Organizations & group practices 2

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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1962748418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "address_2": "SUITE 1022",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213867",
            "telephone_number": "517-263-8905",
            "fax_number": "517-265-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "address_2": "SUITE 1022",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213867",
            "telephone_number": "517-263-8905",
            "fax_number": "517-265-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801095104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.