Individual provider Active NPI

Jennifer Marie Tine, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1336387679
Registry record updated Jul 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076814 Issued in NY
Practice address
356 W 18TH St
New York, NY 10011-4401
Phone
(212) 271-7200
NPI assigned
Jan 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2026

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 076814 NY Primary

Addresses

Primary practice location

356 W 18TH St
New York, NY 10011-4401

Mailing address

356 W 18TH St
New York, NY 10011-4401
Phone (212) 271-7200

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
I20160523001058 NY Practitioner - Clinical Social Worker 5698999803 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076814NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Goodwill Industries of Greater New York and Northern New Jersey, Inc CurrentSince Mar 5, 2016 Accepting new patients
Bridging Access to Care, Inc. CurrentSince Oct 23, 2025 Accepting new patients
Bridging Access to Care, Inc. CurrentSince Oct 23, 2025 Accepting new patients
The Bridge, Inc. PastSince Mar 22, 2020 Accepting new patients

Locations

2261 Church Ave
Brooklyn, NY 11226
Phone (347) 505-5117

390 Berry St
Fl 3
Brooklyn, NY 11249
Phone (347) 393-0020

25 Elm Pl
Fl 3
Brooklyn, NY 11201

Organizations & group practices 4

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": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1336387679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114401",
            "telephone_number": "212-271-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 W 18TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114401",
            "telephone_number": "212-271-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.