JESSICA HENDRICKS (LMSW) – Clinical Social Worker, NPI 1417371501

JESSICA HENDRICKS (LMSW) is a healthcare provider. based in Jackson, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801094426 (MI). The NPI Number for JESSICA HENDRICKS (LMSW) is 1417371501

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA HENDRICKS (LMSW)
NPI
1417371501
Phone
(517) 789-1200
Address
1200 N WEST AVE
Enumeration Date
10 February 2014
Last Update Date
30 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5177891200
Graduation Year
2013 (13 years ago)
PAC ID
1759713266
Group Practice PAC ID
6406808062
Professional Enrollment ID
I20191120003069
Address ID
MI492022179JA1200XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

Provider Addresses for JESSICA HENDRICKS (LMSW)

  • 1200 N WEST AVE

    JACKSON, MI 492022179

    Phone: (517) 789-1200

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191120003069IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49202)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406808062View full group profile
NameSpecialtyState
Mental Health CounselorMI
Mental Health CounselorMI
-MI
Clinical Social WorkerMI
-VA
Clinical Social WorkerMI
Nurse PractitionerMI
Mental Health CounselorMI
Nurse PractitionerMI
Mental Health CounselorFL

Reviews

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Frequently asked questions

Can I cross-check JESSICA HENDRICKS (LMSW) using NPI 1417371501?
NPI 1417371501 belongs to JESSICA HENDRICKS (LMSW); compare other details if you need extra assurance.
Active or inactive — what applies to JESSICA HENDRICKS (LMSW)?
You should see JESSICA HENDRICKS (LMSW) as active in CMS-hosted NPPES data.
What area of care is associated with JESSICA HENDRICKS (LMSW)?
JESSICA HENDRICKS (LMSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is JESSICA HENDRICKS (LMSW) located near Jackson?
JESSICA HENDRICKS (LMSW) currently maps to Jackson, Michigan in this extract.
Can I trust this NPI listing for JESSICA HENDRICKS (LMSW)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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