Jennifer Thieke

Primary specialty

Social WorkerTaxonomy code 104100000X

License

052481-01 Issued in NY

Practice address

6 Coach Hill LN
Northport, NY 11768-3308

Phone

(631) 402-4124

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rachel Lessard LCSW PC

  • Clinical Social Worker
  • Smithtown, NY
  • NPI 1427693217

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1003589573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 COACH HILL LN",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683308",
            "telephone_number": "631-402-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 COACH HILL LN",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683308",
            "telephone_number": "631-402-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEKE",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "052481-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santino Testani, DDS
• Sarah A. Thabet, PT, DPT
• The Bodysattva
• The Dreaming Tree Massage
• The Stop & Shop Supermarket Company LLC
• Catherine Thomas
• Charlene Marie Thomesen, M.D.
• Richard Thomesen, NP
• Jill B Thompson, MD
• Kathleen Thompson, LCSW

• Social Worker in Northport, NY
• Providers in Northport, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.