Individual provider Active NPI

Jessica Sondra Loughlin, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1386889780
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079607 Issued in NY
Practice address
19 W 34TH St PH
New York, NY 10001-3006
Phone
(917) 439-7267
NPI assigned
Dec 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 077877-1 NY
Clinical Social Worker 1041C0700X 44SC05819800 NJ
Clinical Social Worker 1041C0700X 079607 NY Primary

Addresses

Primary practice location

19 W 34TH St PH
New York, NY 10001-3006

Mailing address

198 Bellevue Ave
Montclair, NJ 07043-1892
Phone (917) 439-7267

Other practice location 1

60 8th Ave
Brooklyn, NY 11217-3940
Phone (917) 439-7267 ext. 354

Other practice location 2

60 8th Ave
Brooklyn, NY 11217-3940
Phone (917) 439-7267 ext. 354

Other practice location 3

198 Bellevue Ave
Montclair, NJ 07043
Phone (917) 439-7267

Other practice location 4

171 Madison Ave Fl 5
New York, NY 10016
Phone (917) 439-7267

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
077877-1NYMDSocial Worker
079607NYMDSocial Worker
44SC05819800NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1229212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1386889780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 BELLEVUE AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431892",
            "telephone_number": "917-439-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 34TH ST PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013006",
            "telephone_number": "917-439-7267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112173940",
            "country_code": "US",
            "telephone_number": "917-439-7267 x354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112173940",
            "country_code": "US",
            "telephone_number": "917-439-7267 x354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "198 Bellevue Ave",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "07043",
            "country_code": "US",
            "telephone_number": "917-439-7267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "171 Madison Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "917-439-7267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUGHLIN",
        "first_name": "JESSICA",
        "middle_name": "SONDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-14",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "077877-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05819800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.