Individual provider Active NPI

Jessica Hefele, MSW

  • Early Intervention Provider Agency
  • Brooklyn, NY
National Provider Identifier
1013455229
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Practice address
176 Clarkson Ave Apt 1a
Brooklyn, NY 11226-2028
Phone
(347) 512-9838
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NY Primary
Prevention Professional 405300000X NY

Addresses

Primary practice location

176 Clarkson Ave Apt 1a
Brooklyn, NY 11226-2028

Mailing address

176 Clarkson Ave
1A
Brooklyn, NY 11226-2081
Phone (347) 512-9838

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
I20250404001489 NY Practitioner - Clinical Social Worker 7214451848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
099637NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Mar 1, 2025 Accepting new patients

Locations

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013455229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 CLARKSON AVE",
            "address_2": "1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262081",
            "telephone_number": "347-512-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 CLARKSON AVE APT 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262028",
            "telephone_number": "347-512-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFELE",
        "first_name": "JESSICA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.