Individual provider Active NPI

Jennifer Vetter

  • Clinical Social Worker
  • Selden, NY
National Provider Identifier
1093105355
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3 Denise CT
Selden, NY 11784-4005
Phone
(631) 846-8070
NPI assigned
Jan 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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 Primary

Addresses

Primary practice location

3 Denise CT
Selden, NY 11784-4005

Mailing address

3 Denise CT
Selden, NY 11784-4005
Phone (631) 846-8070

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
I20210323001585 NY Practitioner - Clinical Social Worker 6002223815 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Feb 3, 2021 Accepting new patients
Comprehensive Counseling LCSW, PLLC Clinical CurrentSince Jun 5, 2023 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Feb 3, 2021 Accepting new patients

Locations

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

50 Fountain Plz
Ste 1400
Buffalo, NY 14202
Phone (718) 504-9256

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

1129 Northern Blvd
Ste 404
Manhasset, NY 11030
Phone (516) 305-5531

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 3

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": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1093105355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DENISE CT",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117844005",
            "telephone_number": "631-846-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DENISE CT",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117844005",
            "telephone_number": "631-846-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTER",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selden, NY

Sources for this page

Verify at the official NPI Registry.