Individual provider Active NPI

Jennifer L Haggerty, LMSW

  • Clinical Social Worker
  • Bath, NY
National Provider Identifier
1235374133
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73-081131 Issued in NY
Practice address
76 Veterans Ave
Bath, NY 14810-0810
Phone
(607) 664-4366
NPI assigned
Dec 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 73-081131 NY Primary
School Social Worker 1041S0200X NY

Addresses

Primary practice location

76 Veterans Ave
Bath, NY 14810-0810

Mailing address

76 Veterans Ave
Bath, NY 14810-0810
Phone (607) 664-4366

Other practice location 1

7454 Seneca Rd N
Hornell, NY 14843-9141
Phone (607) 324-2483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629003451 NY Practitioner - Clinical Social Worker 1355700998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians
Brooklyn Womens and Family Counseling Services LCSW PLLCGroup PAC ID 5496645921, 21 clinicians

Practice addresses (Care Compare)

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

7706 13TH Ave
Brooklyn, NY 11228-2414
Phone (718) 232-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73-081131NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Apr 26, 2024 Accepting new patients
Brooklyn Womens & Family Counseling Services LCSW PLLC Clinical CurrentSince May 22, 2023 Accepting new patients
Suny Downstate Medical Center PastSince Apr 26, 2024 Accepting new patients
County of Steuben Past Accepting new patients

Locations

7706 13th Ave
Ste 2
Brooklyn, NY 11228
Phone (718) 313-4357

7706 13th Ave
Brooklyn, NY 11228
Phone (718) 879-8844

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1235374133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7454 Seneca Rd N",
            "address_purpose": "LOCATION",
            "city": "Hornell",
            "state": "NY",
            "postal_code": "148439141",
            "country_code": "US",
            "telephone_number": "607-324-2483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73-081131",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.