Individual provider Active NPI

Jessyka Lynn Lombana

  • Clinical Social Worker
  • Montclair, NJ
National Provider Identifier
1427648336
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05977400 Issued in NJ
Practice address
51 Upper Montclair PLZ Ste 27
Montclair, NJ 07043-1340
Phone
(973) 259-6011
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 095282 NY
Clinical Social Worker 1041C0700X 44SC05977400 NJ Primary

Addresses

Primary practice location

51 Upper Montclair PLZ Ste 27
Montclair, NJ 07043-1340

Mailing address

51 Upper Montclair PLZ Ste 27
Montclair, NJ 07043-1340
Phone (973) 259-6011

Other practice location 1

20 Wilsey Sq
Ridgewood, NJ 07450-3793
Phone (973) 920-3152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 10, 2025 through Apr 10, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC05977400NJMDClinical Social Worker
095282NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1427648336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 UPPER MONTCLAIR PLZ STE 27",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431340",
            "telephone_number": "973-259-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 UPPER MONTCLAIR PLZ STE 27",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431340",
            "telephone_number": "973-259-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Wilsey Sq",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NJ",
            "postal_code": "074503793",
            "country_code": "US",
            "telephone_number": "973-920-3152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOMBANA",
        "first_name": "JESSYKA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095282",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05977400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.