MRS. JACQUELINE SUZANNE BRENNAN, LCSW - NPI NUMBER 1033460118

Summary

Provider Name: MRS. JACQUELINE SUZANNE BRENNAN, LCSW

NPI Number: 1033460118

Clasification: Social Worker (1041C0700X)

Specialization: Clinical

Address:
1435 LIBERTY ST
TRENTON, NJ
ZIP 08629

Phone Number: (609) 599-5433



Detailed Information

MRS. Jacqueline Suzanne Brennan, LCSW is a clinical social worker in Trenton, NJ. The provider is a social worker who holds a master�s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master�s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. The assigned NPI number for this provider is 1033460118 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

1435 LIBERTY ST
TRENTON, NJ
ZIP 08629-220
Phone: (609) 599-5433
Fax: (609) 475-4661

The enumeration date for this NPI number is 9/28/2012 and was last updated on 9/28/2012.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1225431646 ANGELA PUSEY, LCSW
Social Worker (Clinical)
1164796587 MS. ZULINE GRAY WILKINSON, MSW
Social Worker (Clinical)
1780635060 MS. MARYJANE MINDY PADWAL, LCSW
Social Worker (Clinical)
1770827453 NATALIE J PURNELL, LCSW
Social Worker (Clinical)
1073864195 RACHEL ZILBER, LSW
Social Worker
1730430828 MISS BETHANY SUSAN DEGEORGE, LSW
Social Worker
1760552244 MRS. JENNIFER LYNN FAGIN
Social Worker





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 1041C0700X Social Worker Clinical 44SC04590300 NJ Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 0169129 MEDICAID NJ

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1033460118 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name BRENNAN The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name JACQUELINE The first name of the provider, if the provider is an individual.
5 Provider Middle Name SUZANNE The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text MRS. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text LCSW The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 1435 LIBERTY ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name TRENTON The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name NJ The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 086292220 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 6095995433 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 6094754661 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 9/28/2012 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 9/28/2012 The date that a record was last updated or changed.
17 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 1041C0700X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 44SC04590300 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 NJ The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 0169129 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier State 1 NJ
25 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.