Individual provider Active NPI

Jennie Bernstein, LCSW

  • Clinical Social Worker
  • Commack, NY
National Provider Identifier
1275936841
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087108 Issued in NY
Practice address
368 Veterans Hwy Ste 2
Commack, NY 11725
Phone
(631) 486-5140
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 90533 NY
Clinical Social Worker 1041C0700X 087108 NY Primary

Addresses

Primary practice location

368 Veterans Hwy Ste 2
Commack, NY 11725

Mailing address

4 Duke PL
Dix Hills, NY 11746-4813

Other practice location 1

151 Burrs Ln
Dix Hills, NY 11746-6052
Phone (631) 253-3480 ext. 101

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

LicenseStateTypeSpecialty
087108NYMDClinical Social Worker
90533NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sco Family of Services Dba Madonna Heights Service Clinic PastSince Nov 20, 2004 Accepting new patients

Organizations & group practices 1

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1275936841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DUKE PL",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117464813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 VETERANS HWY STE 2",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-486-5140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Burrs Ln",
            "address_purpose": "LOCATION",
            "city": "Dix Hills",
            "state": "NY",
            "postal_code": "117466052",
            "country_code": "US",
            "telephone_number": "631-253-3480 x101",
            "fax_number": "631-253-3483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "JENNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "90533",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.