Jean Hudson Teitelbaum, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO37527-1 Issued in NY

Practice address

103 W Seneca St Ste 303a
Ithaca, NY 14850-4145

Phone

(607) 379-4191

Fax

(607) 272-9454

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1407066178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 MONROE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503444",
            "telephone_number": "607-379-4191",
            "fax_number": "607-272-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W SENECA ST STE 303A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504145",
            "telephone_number": "607-379-4191",
            "fax_number": "607-272-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBAUM",
        "first_name": "JEAN",
        "middle_name": "HUDSON",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO37527-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Tarrow, LCSW
• Lucinda Leigh Tashman, PT
• Carolyn Renee Tavares, RN
• Kathleen D Taves, RN
• Randi Lee Teed
• Robert Teitelbaum, LMFT
• Kiana Marie Telano
• Maglichard Telusma
• Charlene Temple, LCSW-R
• Miria Teneza

• Clinical Social Worker in Ithaca, NY
• Providers in Ithaca, 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 1, 2015; 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.