Jean Louise Augustine, M.A., MSW, MBA
Individual provider Active NPI Social Worker · Warsaw, NY
NPI 1194085175 · NPPES record last updated May 23, 2012
Key facts
- NPI
- 1194085175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- SW007040L (PA)
- Practice address
- 43 Duncan St
Warsaw, NY 14569-1017 - Phone
- (585) 786-8788
- Fax
- (585) 786-8780
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts, Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW007040L | PA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW007040L | PA | Yes |
Addresses
Primary practice location
43 Duncan St
Warsaw, NY 14569-1017
Mailing address
43 Duncan St
Warsaw, NY 14569-1017
Phone (585) 786-8788
Other providers in Warsaw, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2012. 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.