Individual provider Active NPI

Jacqueline Konstandina Lintzeris, LMSW

  • Clinical Social Worker
  • Brewster, NY
National Provider Identifier
1114530185
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092332 Issued in NY
Practice address
1456 Route 22 Ste A103
Brewster, NY 10509-4349
Phone
(845) 276-0460
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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 092332 NY Primary

Addresses

Primary practice location

1456 Route 22 Ste A103
Brewster, NY 10509-4349

Mailing address

14 Nosband Ave Apt 5G
White Plains, NY 10605-2075
Phone (914) 539-7995

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
092332NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1114530185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 NOSBAND AVE APT 5G",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052075",
            "telephone_number": "914-539-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 ROUTE 22 STE A103",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094349",
            "telephone_number": "845-276-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINTZERIS",
        "first_name": "JACQUELINE",
        "middle_name": "KONSTANDINA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.