Individual provider Active NPI

Julie Haussmann, LMSW

  • Social Worker
  • Commack, NY
National Provider Identifier
1063810752
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
062789-1 Issued in NY
Practice address
6080 Jericho Tpke
Commack, NY 11725-2850
Phone
(631) 864-7770
NPI assigned
Dec 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 062789-1 NY Primary

Addresses

Primary practice location

6080 Jericho Tpke
Commack, NY 11725-2850

Mailing address

82 Brooksite Dr
Smithtown, NY 11787-4450
Phone (631) 724-8660

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
062789-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1063810752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BROOKSITE DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874450",
            "telephone_number": "631-724-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 JERICHO TPKE",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252850",
            "telephone_number": "631-864-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSSMANN",
        "first_name": "JULIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "062789-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.