Individual provider Active NPI

Jacquelyn Dolan, LMSW

  • Clinical Social Worker
  • Seaford, NY
National Provider Identifier
1447678701
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099848 Issued in NY
Practice address
2146 Jackson Ave
Seaford, NY 11783-2606
Phone
(516) 622-8888
NPI assigned
Apr 3, 2014
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 099848 NY Primary

Addresses

Primary practice location

2146 Jackson Ave
Seaford, NY 11783-2606

Mailing address

87 N Walnut St
N Massapequa, NY 11758-3015
Phone (516) 384-9296

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
I20250804000148 NY Practitioner - Clinical Social Worker 7416465281 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086159NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Evans Center, Inc CurrentSince Jun 9, 2025 Accepting new patients
Charles Evans Center, Inc. Current Accepting new patients

Locations

857 S Oyster Bay Rd
Bethpage, NY 11714
Phone (516) 622-8888

2146 Jackson Ave
Seaford, NY 11783
Phone (516) 221-3030

Organizations & group practices 2

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1447678701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 N WALNUT ST",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117583015",
            "telephone_number": "516-384-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 JACKSON AVE",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117832606",
            "telephone_number": "516-622-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "JACQUELYN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, NY

Sources for this page

Verify at the official NPI Registry.