Individual provider Active NPI

Andrea P Jaffee, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1326254236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075316-1 Issued in NY
Practice address
136 E 57TH St FL 4
New York, NY 10022-2707
Phone
(212) 935-3030
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 075316-1 NY Primary

Addresses

Primary practice location

136 E 57TH St FL 4
New York, NY 10022-2707

Mailing address

97 Saint Marks PL
Apt #4
New York, NY 10009-5111
Phone (347) 512-8187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 20, 2021 through Mar 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
075316-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326254236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 SAINT MARKS PL",
            "address_2": "APT #4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095111",
            "telephone_number": "347-512-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E 57TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222707",
            "telephone_number": "212-935-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFEE",
        "first_name": "ANDREA",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075316-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.