Individual provider Active NPI

Jennifer Hibbard, LMSW

  • Clinical Social Worker
  • Allegan, MI
National Provider Identifier
1972026482
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
540 Jenner Dr
Allegan, MI 49010-1517
Phone
(269) 257-1062
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801119776 MI
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

540 Jenner Dr
Allegan, MI 49010-1517

Mailing address

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 257-1062

Other identifiers 2

IdentifierTypeStateIssuer
6851115290MedicaidMI
6801119776MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250703002345 MN Practitioner - Clinical Social Worker 8022522812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801119776MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Robbins Current Accepting new patients
Wild Tree Psychotherapy, LLC CurrentSince Jun 19, 2025 Accepting new patients
Sarah C. Chambers, P.a. Past Accepting new patients
Allegan County Community Mental Health Services Past Accepting new patients

Locations

906 Vermillion St
Hastings, MN 55033
Phone (651) 212-4920

653 Grand Ave
Saint Paul, MN 55105
Phone (651) 212-4920

Organizations & group practices 4

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1972026482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-257-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-257-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBARD",
        "first_name": "JENNIFER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119776",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6851115290",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801119776",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

Verify at the official NPI Registry.