Individual provider Active NPI

Alejandra Devine, LMSW

  • Social Worker
  • Port Jefferson, NY
National Provider Identifier
1538870837
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
109098-01 Issued in NY
Practice address
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone
(631) 742-0529
NPI assigned
Dec 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 109098-01 NY Primary

Addresses

Primary practice location

75 N Country Rd
Port Jefferson, NY 11777-2119

Mailing address

12 Chatham Dr
Oakdale, NY 11769-1402
Phone (631) 742-0529

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

State licenses

LicenseStateTypeSpecialty
109098-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1538870837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CHATHAM DR",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691402",
            "telephone_number": "631-742-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772119",
            "telephone_number": "631-742-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "ALEJANDRA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109098-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.