Individual provider Active NPI

Jennifer Mann, LCSW

  • Clinical Social Worker
  • Chappaqua, NY
National Provider Identifier
1114472156
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097712 Issued in NY
Practice address
50 Kipp St
Chappaqua, NY 10514-2519
Phone
(929) 242-9326
NPI assigned
Aug 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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 097712 NY Primary

Addresses

Primary practice location

50 Kipp St
Chappaqua, NY 10514-2519

Mailing address

50 Kipp St
Chappaqua, NY 10514-2519
Phone (914) 263-7620

Other practice location 1

1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 987-3063

Other practice location 2

244 5th Ave Fl 10
New York, NY 10001-7932
Phone (929) 242-9326

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
097712NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1114472156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KIPP ST",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105142519",
            "telephone_number": "914-263-7620",
            "fax_number": "212-987-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KIPP ST",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105142519",
            "telephone_number": "929-242-9326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-987-3063",
            "fax_number": "212-987-6322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "244 5th Ave Fl 10",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100017932",
            "country_code": "US",
            "telephone_number": "929-242-9326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chappaqua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.