Individual provider Active NPI

Lorna Jane, LICSW

  • Clinical Social Worker
  • Long Island City, NY
National Provider Identifier
1104974252
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1032141 Issued in MA
Practice address
5203 Center Blvd Apt 2706
Long Island City, NY 11101-6672
Phone
(173) 653-8376
Fax
(187) 868-7147
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 094621 NY
Clinical Social Worker 1041C0700X 1032141 MA Primary
Clinical Social Worker 1041C0700X LC22356 ME

Addresses

Primary practice location

5203 Center Blvd Apt 2706
Long Island City, NY 11101-6672

Mailing address

5203 Center Blvd Apt 2706
Long Island City, NY 11101-6672
Phone (617) 365-3757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050916000172 MA Practitioner - Clinical Social Worker 4284667544 Practice locations: Newton Centre, MA
I20230112001183 NY Practitioner - Clinical Social Worker 4284667544 Practice locations: Long Island City, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5203 Ctr Blvd
Apt 2706
Long Island City, NY 11101-6672
Phone (617) 365-3757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1032141MAMDClinical Social Worker
LC22356MEMDClinical Social Worker
094621NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1104974252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 CENTER BLVD APT 2706",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016672",
            "telephone_number": "617-365-3757",
            "fax_number": "718-786-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 CENTER BLVD APT 2706",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016672",
            "telephone_number": "173-653-8376",
            "fax_number": "187-868-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANE",
        "first_name": "LORNA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094621",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1032141",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC22356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.