Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jenna Staub, LCSW-A, LCAS-A

Individual provider Behavior Technician · NPI 1629673835

Jenna Staub, LCSW-A, LCAS-A is a Clinical Social Worker in Wilmington, North Carolina. Qualified in 2023, 3 years ago. Works from 2 locations. Licensed in North Carolina.

Years since qualifying
3
Licensed in
NC
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

503 Covil Ave Ste 102
Wilmington, NC 28403-2683
Phone: (910) 995-4154
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 421 Fayetteville St Ste 1100, Raleigh, NC 27601-3000 — (877) 418-2978

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 29080 (NC)
Behavior Technician Taxonomy 106S00000X (NC)

Record details

NPI number1629673835
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW-A , LCAS-A
Sole proprietorNo
NPI enumeratedDecember 3, 2020
Last updated in NPPESApril 13, 2024
Certification dateApril 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Wilmington