Jacqueline Pam Morrison, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

079930 Issued in NY

Practice address

21 Willow Pond Way Ste 103
Penfield, NY 14526-2687

Phone

(585) 385-6030

Fax

(585) 385-6168

NPI assigned

Oct 9, 2018

Last updated

Oct 9, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Agape Counseling Associates Inc

  • Clinical Social Worker
  • Penfield, NY
  • NPI 1174657712
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1073088787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 EDGEWOOD DR",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262204",
            "telephone_number": "585-385-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW POND WAY STE 103",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262687",
            "telephone_number": "585-385-6030",
            "fax_number": "585-385-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "JACQUELINE",
        "middle_name": "PAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Mohammed, RN
• Christopher D Momot, M.D.
• Monroe County Chiropractic, P.C.
• Brigid Moore
• Shandalie Morales
• Ola Mscichowski, MD
• Lindsey Muller, RPH
• Joan Haines Mullings, AU.D.
• Joseph Muscarella
• Abigal J Myslivecek, LMSW

• Clinical Social Worker in Penfield, NY
• Providers in Penfield, 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 Oct 9, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.