Active NPI
Annie Abraham John, LCSW
- Clinical Social Worker
- Jamaica, NY
National Provider Identifier
1164569745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R053647-1
- Practice address
- 8956 162ND St
Jamaica, NY 11432-5072 - Phone
- (718) 657-7100
- Fax
- (718) 657-7137
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R053647-1 | NY | Primary |
Addresses
Primary practice location
8956 162ND St
Jamaica, NY 11432-5072
Mailing address
25 Border St
Hicksville, NY 11801-3756
Phone (516) 390-5621
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R053647-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164569745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 BORDER ST",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118013756",
"telephone_number": "516-390-5621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8956 162ND ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114325072",
"telephone_number": "718-657-7100",
"fax_number": "718-657-7137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHN",
"first_name": "ANNIE",
"middle_name": "ABRAHAM",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R053647-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.