Individual provider Active NPI

Carol Jobson, LCSW-R

  • Clinical Social Worker
  • Roosevelt, NY
National Provider Identifier
1144650557
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R038629-1 Issued in NY
Practice address
380 Nassau Rd
LL
Roosevelt, NY 11575-1343
Phone
(516) 623-7741
Fax
(516) 623-7775
NPI assigned
Nov 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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 R038629-1 NY Primary

Addresses

Primary practice location

380 Nassau Rd
LL
Roosevelt, NY 11575-1343

Mailing address

25315 148TH Ave
Rosedale, NY 11422-2829
Phone (516) 623-7741

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
I20250121001112 NY Practitioner - Clinical Social Worker 9032498977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R038629-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1144650557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25315 148TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222829",
            "telephone_number": "516-623-7741",
            "fax_number": "516-623-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 NASSAU RD",
            "address_2": "LL",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751343",
            "telephone_number": "516-623-7741",
            "fax_number": "516-623-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBSON",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038629-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

Verify at the official NPI Registry.