Individual provider Active NPI

Jade Heitner, LCSW

  • Clinical Social Worker
  • Riverhead, NY
National Provider Identifier
1003712092
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099605 Issued in NY
Practice address
275 Newton Ave
Riverhead, NY 11901-4712
Phone
(646) 431-5546
NPI assigned
Oct 16, 2026
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 099605 NY Primary

Addresses

Primary practice location

275 Newton Ave
Riverhead, NY 11901-4712

Mailing address

275 Newton Ave
Riverhead, NY 11901-4712
Phone (646) 431-5546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1792108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1003712092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 NEWTON AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014712",
            "telephone_number": "646-431-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NEWTON AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014712",
            "telephone_number": "646-431-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITNER",
        "first_name": "JADE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-16",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.