Individual provider Active NPI

Jennifer Bair, LCSW

  • Clinical Social Worker
  • Victor, NY
National Provider Identifier
1013287333
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083490 Issued in NY
Practice address
6539 Anthony Dr Ste a
Victor, NY 14564-1441
Phone
(585) 398-8835
Fax
(585) 398-7376
NPI assigned
Jan 3, 2012
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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 083490 NY Primary

Addresses

Primary practice location

6539 Anthony Dr Ste a
Victor, NY 14564-1441

Mailing address

6539 Anthony Dr Ste a
Victor, NY 14564-1441
Phone (585) 398-8835

Other practice location 1

150 East Dr
Copiague, NY 11726-5104
Phone (516) 972-7233

Other identifiers 1

IdentifierTypeStateIssuer
03003069MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151013001378 NY Practitioner - Clinical Social Worker 4082923065 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Aug 11, 2021 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Aug 12, 2021 Accepting new patients
Welllife Network Inc CurrentSince Apr 1, 2016 Accepting new patients
Christopher Dennis MD PLLC Clinical CurrentSince Apr 1, 2021 Accepting new patients
Welllife Network Inc., CurrentSince Apr 1, 2016 Accepting new patients
Welllife Network Inc. Past Accepting new patients

Locations

2510 Westchester Ave
Fl 2
Bronx, NY 10461
Phone (718) 824-2790

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

3600 Route 112
Coram, NY 11727
Phone (631) 854-2100

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

14202 20th Ave
#3
Flushing, NY 11351

14202 20th Ave
Fl 3
Flushing, NY 11351
Phone (718) 559-0516

800 Northern Blvd
Great Neck, NY 11021
Phone (516) 829-8450

55 Horizon Dr
Huntington, NY 11743
Phone (631) 396-2300

20905 Jamaica Ave
Queens Village, NY 11428
Phone (631) 920-8302

510 Clinton Sq
Rochester, NY 14604
Phone (561) 208-1970

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

11 Route 111
Smithtown, NY 11787
Phone (631) 656-9550

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1013287333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6539 ANTHONY DR STE A",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641441",
            "telephone_number": "585-398-8835",
            "fax_number": "585-398-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6539 ANTHONY DR STE A",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641441",
            "telephone_number": "585-398-8835",
            "fax_number": "585-398-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 East Dr",
            "address_purpose": "LOCATION",
            "city": "Copiague",
            "state": "NY",
            "postal_code": "117265104",
            "country_code": "US",
            "telephone_number": "516-972-7233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAIR",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03003069",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

Verify at the official NPI Registry.