Individual provider Active NPI

Jeannette Mendez Santacruz, LCSW-R

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1023166006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R070621-1 Issued in NY
Practice address
260 E 188TH St
5TH Floor
Bronx, NY 10458-5302
Phone
(718) 960-0286
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R070621-1 NY Primary

Addresses

Primary practice location

260 E 188TH St
5TH Floor
Bronx, NY 10458-5302

Mailing address

112 Pine Ave
Ossining, NY 10562-3718
Phone (914) 923-7093

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

State licenses

LicenseStateTypeSpecialty
R070621-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023166006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PINE AVE",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105623718",
            "telephone_number": "914-923-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E 188TH ST",
            "address_2": "5TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585302",
            "telephone_number": "718-960-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTACRUZ",
        "first_name": "JEANNETTE",
        "middle_name": "MENDEZ",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R070621-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.