Active NPI
Sandrine Marie Cecile Etienne, LMSW
- Social Worker
- Jamaica, NY
National Provider Identifier
1245746569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 079047-1
- Practice address
- 10724 155TH St
Jamaica, NY 11433-1924 - Phone
- (917) 723-2951
- NPI assigned
- Dec 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 079047-1 | NY | Primary |
Addresses
Primary practice location
10724 155TH St
Jamaica, NY 11433-1924
Mailing address
10724 155TH St
Jamaica, NY 11433-1924
Phone (917) 723-2951
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
| License | State | Type | Specialty |
|---|---|---|---|
| 079047-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513814400000",
"number": "1245746569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10724 155TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114331924",
"telephone_number": "917-723-2951",
"fax_number": "347-809-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10724 155TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114331924",
"telephone_number": "917-723-2951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "SANDRINE",
"middle_name": "MARIE CECILE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-21",
"last_updated": "2017-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NY",
"license": "079047-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.