Individual provider Active NPI

Jessica McGinn, LCSW

  • Clinical Social Worker
  • Dix Hills, NY
National Provider Identifier
1508330374
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096672 Issued in NY
Practice address
197 Half Hollow Rd
Dix Hills, NY 11746-5859
Phone
(631) 370-1800
Fax
(631) 370-1714
NPI assigned
Jan 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 096672 NY Primary

Addresses

Primary practice location

197 Half Hollow Rd
Dix Hills, NY 11746-5859

Mailing address

197 Half Hollow Rd
Dix Hills, NY 11746-5859
Phone (631) 370-1800

Other identifiers 1

IdentifierTypeStateIssuer
1386817906MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096672NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1508330374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 HALF HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465859",
            "telephone_number": "631-370-1800",
            "fax_number": "631-370-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 HALF HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465859",
            "telephone_number": "631-370-1800",
            "fax_number": "631-370-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINN",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386817906",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.