Individual provider Active NPI

Jill Sukenick I, MSW, PH.D.

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1497108815
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R025478 Issued in NY
Practice address
120 E 62ND St
Suite 1B
New York, NY 10065-8149
Phone
(212) 872-1530
NPI assigned
Jul 20, 2016
Last updated
Jul 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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 R025478 NY Primary

Addresses

Primary practice location

120 E 62ND St
Suite 1B
New York, NY 10065-8149

Mailing address

114 E 84TH St
Apt 5D
New York, NY 10028-0919
Phone (212) 872-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R025478NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1497108815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E 84TH ST",
            "address_2": "APT 5D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280919",
            "telephone_number": "212-872-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 62ND ST",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658149",
            "telephone_number": "212-872-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKENICK",
        "first_name": "JILL",
        "name_suffix": "I",
        "credential": "MSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R025478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.