Individual provider Active NPI

Jessmina Archbold, LMSW

  • Social Worker
  • Forest Hills, NY
National Provider Identifier
1225427321
Registry record updated Oct 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
094804 Issued in NY
Practice address
7050 Austin St Ste 113
Forest Hills, NY 11375-4746
Phone
(347) 445-0543
NPI assigned
Jan 13, 2015
Last updated
Oct 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 094804 NY Primary

Addresses

Primary practice location

7050 Austin St Ste 113
Forest Hills, NY 11375-4746

Mailing address

7050 Austin St Ste 113
Forest Hills, NY 11375-4746
Phone (347) 445-0543

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
094804NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475280000000",
    "number": "1225427321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 AUSTIN ST STE 113",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754746",
            "telephone_number": "347-445-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 AUSTIN ST STE 113",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754746",
            "telephone_number": "347-445-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHBOLD",
        "first_name": "JESSMINA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2016-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; 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.