Individual provider Active NPI

Jessie A Notch-Leblanc, LCSW

  • Clinical Social Worker
  • Plattsburgh, NY
National Provider Identifier
1255443719
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077981-R Issued in NY
Practice address
22 US Oval Ste 123
Plattsburgh, NY 12903-5901
Phone
(518) 802-7000
NPI assigned
Aug 31, 2006
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 077981-R NY Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

22 US Oval Ste 123
Plattsburgh, NY 12903-5901

Mailing address

22 US Oval Ste 123
Plattsburgh, NY 12903-5901
Phone (518) 802-7000

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
I20110805000576 NY Practitioner - Clinical Social Worker 9032388129 Reassigns benefits to 1 organization
Practice locations: Plattsburgh, NY

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

Practice addresses (Care Compare)

22 US Oval
Suite 123
Plattsburgh, NY 12903-5901
Phone (518) 802-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077981-RNYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton County Addiction (Substance Use Disorder) CurrentSince Jul 3, 2011 Accepting new patients
Clinton County CurrentSince Jul 3, 2011 Accepting new patients
Northeast Therapy Associates, LCSW, PLLC Clinical CurrentSince Aug 3, 2025 Accepting new patients

Locations

22 US Oval
Ste 123
Plattsburgh, NY 12903
Phone (518) 578-3380

130 Arizona Ave
Ste 1500
Plattsburgh, NY 12903
Phone (518) 565-4060

18 Ampersand Dr
Plattsburgh, NY 12901
Phone (518) 565-4060

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1255443719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 US OVAL STE 123",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129035901",
            "telephone_number": "518-802-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 US OVAL STE 123",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129035901",
            "telephone_number": "518-802-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTCH-LEBLANC",
        "first_name": "JESSIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077981-R",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.