Individual provider Active NPI

Jeanine Marie Warns, LCSW,CASAC

  • Clinical Social Worker
  • Mattituck, NY
National Provider Identifier
1336264092
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077132-1 Issued in NY
Practice address
13235 Main Rd
Mattituck, NY 11952
Phone
(631) 965-7750
Fax
(631) 298-4344
NPI assigned
Mar 20, 2007
Last updated
Aug 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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 077132-1 NY Primary

Addresses

Primary practice location

13235 Main Rd
Mattituck, NY 11952

Mailing address

13235 Main Rd
Mattituck, NY 11952
Phone (631) 965-7750

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
I20160927000307 NY Practitioner - Clinical Social Worker 0244527778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service League IncGroup PAC ID 4284524448, 47 clinicians

Practice addresses (Care Compare)

7555 Main Rd
Mattituck, NY 11952-1516
Phone (631) 298-8642

790 Park Ave
Huntington, NY 11743-4516
Phone (631) 427-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077132-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Jun 25, 2016 Accepting new patients

Locations

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

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, 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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1336264092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13235 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "11952",
            "telephone_number": "631-965-7750",
            "fax_number": "631-298-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13235 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "11952",
            "telephone_number": "631-965-7750",
            "fax_number": "631-298-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNS",
        "first_name": "JEANINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW,CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077132-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattituck, NY

Sources for this page

Verify at the official NPI Registry.