Jaclyn Levine, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

087288-1 Issued in NY

Practice address

363 Route 111 Ste 103
Smithtown, NY 11787-4750

Phone

(631) 240-3031

NPI assigned

Mar 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661558400000",
    "number": "1457744328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111 STE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874750",
            "telephone_number": "631-240-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ROUTE 111 STE 103",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874750",
            "telephone_number": "631-240-3031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Route 111",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117873753",
            "country_code": "US",
            "telephone_number": "631-920-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JACLYN",
        "name_prefix": "Miss",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2022-08-27",
        "certification_date": "2022-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092770-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087288-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Lessard, LCSW
• Donna Lesser, D.O.
• Michele Lester, DDS
• Jennifer Elizabeth Leupold, L.AC.
• Laurel Levin, LCSW
• Adrienne Sara Levy, MD
• Eileen Levy, NPP
• Laurence Deborah Levy, MD
• Richard B Lewin, MD
• Daniel Lewis, RPH

• Clinical Social Worker in Smithtown, NY
• Providers in Smithtown, 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 Aug 27, 2022; 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.