Colleen Jeffus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086436 Issued in NY

Practice address

456 Waverly Ave
Patchogue, NY 11772-1586

Phone

(631) 447-6460

NPI assigned

Sep 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Federation of Organizations for the Ny State Mentally Disabled Inc

  • Community/Behavioral Health Agency
  • West Babylon, NY
  • NPI 1346433307
  Medicare reassignment NPD
• Federation of Organizations for the Ny State Mentally Disabled Inc

  • Adult Mental Health Clinic/Center
  • Brooklyn, NY
  • NPI 1316006042
  NPD
• Risewell Community Services

  • Counselor
  • Copiague, NY
  • NPI 1396102091
  NPD

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1386045524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 WAVERLY AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721586",
            "telephone_number": "631-447-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 WAVERLY AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721586",
            "telephone_number": "631-447-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFUS",
        "first_name": "COLLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086436",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092650-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Ann James-Katz, CCC-SLP
• Steven Jankowski, PA-C
• Todd M Jarrell, MD
• Jay B Stambler MD Medical PC
• Ronie Jean-Philippe, RPA-C
• Erica K Jess, LPN
• Jessica Wood Pediatric Nurse Practitioner PLLC
• Zaiwang Paul Jin, MD
• Joann Spinnato Pediatric NP PLLC
• John Shinin, MD.PC

• Clinical Social Worker in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.