Individual provider Active NPI

Jennifer Wenderoth, LISW

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1972957314
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0900032 Issued in OH
Practice address
4269 Pearl Rd
Cleveland, OH 44109-4234
Phone
(216) 431-4131
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0900032 OH Primary

Addresses

Primary practice location

4269 Pearl Rd
Cleveland, OH 44109-4234

Mailing address

4269 Pearl Rd
Cleveland, OH 44109-4234
Phone (216) 431-4131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0900032OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1972957314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4269 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094234",
            "telephone_number": "216-431-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4269 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094234",
            "telephone_number": "216-431-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDEROTH",
        "first_name": "JENNIFER",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0900032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.