Jennifer Powell, LCSW

Individual provider Active NPI Clinical Social Worker · Granville, NY

NPI 1205245396 · NPPES record last updated Aug 4, 2014

Key facts

NPI
1205245396
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
082074 (NY)
Practice address
58 Quaker St
Granville, NY 12832-1513
Phone
(518) 642-1051
Fax
(518) 642-4544
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
082074NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Granville Central School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082074 NY Yes

Addresses

Primary practice location

58 Quaker St
Granville, NY 12832-1513

Mailing address

58 Quaker St
Granville, NY 12832-1513
Phone (518) 642-1051

Other providers in Granville, NY

All providers in Granville, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.