Individual provider Active NPI

Jeanne Vecchio, LCSW-R

  • Clinical Social Worker
  • Huntington, NY
National Provider Identifier
1033214895
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-044316-1 Issued in NY
Practice address
775 Park Ave
Suite 101
Huntington, NY 11743-3976
Phone
(621) 427-1100
Fax
(631) 784-7748
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

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 R-044316-1 NY Primary

Addresses

Primary practice location

775 Park Ave
Suite 101
Huntington, NY 11743-3976

Mailing address

775 Park Ave
Suite 101
Huntington, NY 11743-3976
Phone (621) 427-1100

Other identifiers 1

IdentifierTypeStateIssuer
02112861MedicaidNY

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
I20050606001127 NY Practitioner - Clinical Social Worker 8426091943 Practice locations: Baiting Hollow, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3102 Fox Hill Dr
Baiting Hollow, NY 11933-1395
Phone (631) 819-2485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-044316-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Juliana Kanji Psychiatric Services, PC Past Accepting new patients

Organizations & group practices 1

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033214895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PARK AVE",
            "address_2": "SUITE 101",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433976",
            "telephone_number": "621-427-1100",
            "fax_number": "631-784-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PARK AVE",
            "address_2": "SUITE 101",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433976",
            "telephone_number": "621-427-1100",
            "fax_number": "631-784-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VECCHIO",
        "first_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-044316-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02112861",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.