Jesse R Northridge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW021046 Issued in PA

Practice address

22 Northeast Dr
Hershey, PA 17033-2732

Phone

(717) 531-8338

Fax

(717) 531-6250

NPI assigned

Dec 18, 2017

Last updated

Feb 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1265948079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 NORTHEAST DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332732",
            "telephone_number": "717-531-8338",
            "fax_number": "717-531-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRIDGE",
        "first_name": "JESSE",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW134804",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Noonan, PT, DPT
• Jawad Noor, M.D.
• Mohammad Anwar Noory
• Andrea Noronha
• Jaclyn Suzanne Northridge, LCSW
• Geoffrey Nosker, M.D.
• Jessica Nourse, CCC-SLP
• Lara N Novak, PA-C
• Michael Ikechukwu Nsaka
• Matthew S Nudy, MD

• Clinical Social Worker in Hershey, PA
• Providers in Hershey, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.