Active NPI
Jeannine Marie Wilkinson, LMSW, SSW
- Clinical Social Worker
- Kenockee, MI
National Provider Identifier
1972254100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801106029
- Practice address
- 9765 Rynn Rd
Kenockee, MI 48006-4010 - Phone
- (231) 250-7557
- NPI assigned
- Jan 10, 2022
- 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 | 6801106029 | MI | Primary |
Addresses
Primary practice location
9765 Rynn Rd
Kenockee, MI 48006-4010
Mailing address
9765 Rynn Rd
Kenockee, MI 48006-4010
Phone (231) 250-7557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891596 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801106029 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1972254100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9765 RYNN RD",
"city": "KENOCKEE",
"state": "MI",
"postal_code": "480064010",
"telephone_number": "231-250-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9765 RYNN RD",
"city": "KENOCKEE",
"state": "MI",
"postal_code": "480064010",
"telephone_number": "231-250-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "JEANNINE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LMSW, SSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-10",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801106029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891596",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenockee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.