Jennifer Fazio, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091960 Issued in NY

Practice address

2233 Nesconset Hwy
Suite 104
Lake Grove, NY 11755-1000

Phone

(631) 737-5559

Fax

(631) 737-0001

NPI assigned

Nov 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Donna Riley Office of Licensed Clinical Social Work PLLCGroup PAC ID 6507253754, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Donna Riley Office of Licensed Clinical Social Work, PLLC

  • Clinical Social Worker
  • Lake Grove, NY
  • NPI 1811649833
  Medicare reassignment Care Compare group NPD
• The Freedman-Cuttler Group of Clinical Social Workers, PLLC

  • Clinical Social Worker
  • Smithtown, NY
  • NPI 1528223401
  NPD (past)

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1245635259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "address_2": "SUITE 104",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-737-5559",
            "fax_number": "631-737-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "address_2": "SUITE 104",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-737-5559",
            "fax_number": "631-737-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-03",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Coast Fertility, P.C.
• Cheryl Edelman II
• Yolette Emmanuel, LPN
• Giuditta D Esposito, LCSW
• Emily Rose Farina, PA-C
• Ting Yu Feng
• Christina Feuge
• Janet Lynn Flood, RN
• A Irina Foucher
• Marc Foucher

• Clinical Social Worker in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.