Active NPI
Jacqueline S Oertel, LCSW
- Clinical Social Worker
- Plattsburgh, NY
National Provider Identifier
1528076254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R042722-1
- Practice address
- 174 US Oval
Plattsburgh, NY 12903-3900 - Phone
- (518) 324-5727
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R042722-1 | NY | Primary |
Addresses
Primary practice location
174 US Oval
Plattsburgh, NY 12903-3900
Mailing address
174 US Oval
Plattsburgh, NY 12903-3900
Phone (518) 324-5727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4034838 | Other | NY | TRICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R042722-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528076254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 US OVAL",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129033900",
"telephone_number": "518-324-5727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 US OVAL",
"city": "PLATTSBURGH",
"state": "NY",
"postal_code": "129033900",
"telephone_number": "518-324-5727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OERTEL",
"first_name": "JACQUELINE",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R042722-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "4034838",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plattsburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.