Individual provider Active NPI

Jennifer C Camacho

  • Clinical Social Worker
  • Franklin Square, NY
National Provider Identifier
1225205289
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074756-1 Issued in NY
Practice address
1085 Russell St
Franklin Square, NY 11010-2603
Phone
(516) 352-0297
NPI assigned
May 9, 2008
Last updated
Feb 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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 074756-1 NY Primary

Addresses

Primary practice location

1085 Russell St
Franklin Square, NY 11010-2603

Mailing address

1085 Russell St
Franklin Square, NY 11010-2603
Phone (516) 352-0297

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
074756-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1225205289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 RUSSELL ST",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110102603",
            "telephone_number": "516-352-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 RUSSELL ST",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110102603",
            "telephone_number": "516-352-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074756-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Square, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.