Jennifer Lyn Bordonaro-Benson, LCSW
Individual provider Active NPI Clinical Social Worker · Baldwinsville, NY
NPI 1487723045 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1487723045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 071304-1 (NY)
- Practice address
- 3070 Belgium Rd
Baldwinsville, NY 13027 - Phone
- (315) 253-8401
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251003000900 | NY | Order and Referring Only - Clinical Social Worker | 7113938101 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071304-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 071304-1 | NY | Yes |
Addresses
Primary practice location
3070 Belgium Rd
Baldwinsville, NY 13027
Mailing address
6760 Minoa Bridgeport Rd
East Syracuse, NY 13057-9424
Phone (315) 857-5256
Other practice location 1
620 Madison St
Syracuse, NY 13210-2319
Phone (315) 426-3600
Other names
- Jennifer Lyn Bordonaro
Other providers in Baldwinsville, NY
- Cassandra Sage Bluff
- Elizabeth Blume
- Tracy Lynn Boisey
- Kimberly Ann Bono
- Lynda L. Bookman
- Jenna Boutilier
- Melissa Renee Bouvia
- Joanne L Bowen
- Britany Brancheau
- Jill Braun
All providers in Baldwinsville, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.