Jennifer Thieke

Primary specialty

Social WorkerTaxonomy code 104100000X

License

052481-01 Issued in NY

Practice address

1227 Main St
Port Jefferson, NY 11777-2227

Phone

(516) 946-3495

NPI assigned

Jul 29, 2021

Last updated

Oct 22, 2026By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rachel Lessard LCSW PC

  dba Pathways Within

  • Clinical Social Worker
  • Smithtown, NY
  • NPI 1427693217

  Single Specialty

  Medicare reassignment NPD
• Susan Goryeb Simms, Licensed Clinical Social Worker, PC

  • Clinical Social Worker
  • Port Jefferson, NY
  • NPI 1821694928

  Single Specialty

  NPD

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "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": "1227 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772227",
            "telephone_number": "516-946-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEKE",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "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": []
}

• Bonnie Taub, LMT
• Michael Kenneth Tax, LPN
• Lisa Taxman Goldfarb, PH.D.
• The Community Programs Center of L.I. (Day Haven Adult Day Services)
• The Way Back, Inc.
• Dinushan Thirumavalavan, D.O.
• Elizabeth Ann Thomas-Lov, P.T.
• Christina Thompson, PA
• Petrel Thompson
• Three Village Medicine PC

• Social Worker in Port Jefferson, NY
• Providers in Port Jefferson, 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 Oct 22, 2026; 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.