Jennifer K Bourdette
Individual provider Active NPI Social Worker · Canton, NY
NPI 1124855408 · NPPES record last updated Sep 19, 2024
Key facts
- NPI
- 1124855408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 22 State Highway 310
Canton, NY 13617-1459 - Phone
- (315) 386-0264
- NPI assigned
- Sep 19, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Helpers Care Inc | Past |
Accepting new patients | |
| United Helpers Care Inc | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BIJFDD/Endpoint/BIJFDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
22 State Highway 310
Canton, NY 13617-1459
Mailing address
661 Judson Street Rd
Canton, NY 13617-3944
Phone (315) 244-0451
Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.