Active NPI
Jessica Lopez
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1548752579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 119 Schenectady Ave
Brooklyn, NY 11213-2330 - Phone
- (347) 915-1112
- Fax
- (347) 915-1113
- NPI assigned
- Jun 5, 2018
- 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 | NY | Primary |
Addresses
Primary practice location
119 Schenectady Ave
Brooklyn, NY 11213-2330
Mailing address
119 Schenectady Ave
Brooklyn, NY 11213-2330
Phone (347) 915-1112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16799220490 | Medicaid | NY |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Future for the Children | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Brooklyn, NY
- NPI 1679920490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528156800000",
"number": "1548752579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 SCHENECTADY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112132330",
"telephone_number": "347-915-1112",
"fax_number": "347-915-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 SCHENECTADY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112132330",
"telephone_number": "347-915-1112",
"fax_number": "347-915-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2018-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16799220490",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.