Rachel Jividen, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096645-1 Issued in NY

Practice address

1019 E Water St
Elmira, NY 14901-3332

Phone

(607) 733-5696

NPI assigned

Jan 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Counseling Practicing Licensed Clinical Social Work PLLCGroup PAC ID 4284008889, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renew Counseling Practicing Licensed Clinical Social Work PLLC

  • Clinical Social Worker
  • Corning, NY
  • NPI 1497451769
  Medicare reassignment Care Compare group NPD
• Milissa B Cerio, LCSWR, CASAC

  • Social Worker
  • Elmira, NY
  • NPI 1730228636
  Medicare reassignment
• J & J Partner Consulting, LLC

  • Mental Health Counselor
  • Corning, NY
  • NPI 1841004967
  NPD
• Milissa Cerio

  • Social Worker
  • Elmira, NY
  • NPI 1548479843
  NPD

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1053700211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332",
            "telephone_number": "607-733-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIVIDEN",
        "first_name": "RACHEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096645-1",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Theresa Jaynes, RN
• Angela Jennings
• Cheyenne Jerzak-Coon
• Arlene Jerzak, RN
• Monica Jerzak
• Joanne Wu
• Kira Johns, B.S.
• Bobbie Jo Johnson, MSW
• Lori Ann Johnson, LMSW
• Nichole Johnson, MHC

• Clinical Social Worker in Elmira, NY
• Providers in Elmira, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.