Individual provider Active NPI

Jennifer Lynne Kogan, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1992831150
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC302938 Issued in DC
Practice address
5247 Wisconsin Ave NW
Suite 2
Washington, DC 20015-2012
Phone
(202) 215-2790
NPI assigned
Feb 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LC302938 DC Primary

Addresses

Primary practice location

5247 Wisconsin Ave NW
Suite 2
Washington, DC 20015-2012

Mailing address

5508 30TH PL NW
Washington, DC 20015-1210
Phone (202) 215-2790

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2018 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC302938DCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992831150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 30TH PL NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200151210",
            "telephone_number": "202-215-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 WISCONSIN AVE NW",
            "address_2": "SUITE 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152012",
            "telephone_number": "202-215-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC302938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.