Individual provider Active NPI

Jacqueline Gathers, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1366154338
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
10974 Issued in NY
Practice address
2425 Westchester Ave
Bronx, NY 10461-3540
Phone
(718) 430-1313
Fax
(929) 448-2389
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10974 NY Primary

Addresses

Primary practice location

2425 Westchester Ave
Bronx, NY 10461-3540

Mailing address

1870A Story Ave
Bronx, NY 10473-3240
Phone (718) 828-7123

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
10974NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1366154338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870A STORY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104733240",
            "telephone_number": "718-828-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613540",
            "telephone_number": "718-430-1313",
            "fax_number": "929-448-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATHERS",
        "first_name": "JACQUELINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "10974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.