Individual provider Active NPI

Catherine Jacklin, LCSW

  • Social Worker
  • Manhasset, NY
National Provider Identifier
1417336926
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
088608 Issued in NY
Practice address
600 Community Dr
Suite 400
Manhasset, NY 11030-3802
Phone
(516) 427-9696
NPI assigned
May 29, 2015
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 090314 NY
Social Worker 104100000X 088608 NY Primary

Addresses

Primary practice location

600 Community Dr
Suite 400
Manhasset, NY 11030-3802

Mailing address

600 Community Dr
Suite 400
Manhasset, NY 11030-3802

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
I20210421002007 NY Practitioner - Clinical Social Worker 5597173047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
088608NYMDSocial Worker
090314NYMDSocial Worker

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1417336926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COMMUNITY DR",
            "address_2": "SUITE 400",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COMMUNITY DR",
            "address_2": "SUITE 400",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303802",
            "telephone_number": "516-427-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKLIN",
        "first_name": "CATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090314",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.