Individual provider Active NPI

Jessie Wilkinson, LCSW

  • Clinical Social Worker
  • Patchogue, NY
National Provider Identifier
1578056412
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087020 Issued in NY
Practice address
20 Medford Ave Ste 110
Patchogue, NY 11772-1220
Phone
(473) 779-1186
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 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 087020 NY Primary

Addresses

Primary practice location

20 Medford Ave Ste 110
Patchogue, NY 11772-1220

Mailing address

20 Medford Ave Ste 110
Patchogue, NY 11772-1220
Phone (347) 779-1186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712000144 NY Practitioner - Clinical Social Worker 0648526202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Visiting Counselors of New York, LCSW, PLLCGroup PAC ID 4688932106, 26 clinicians

Practice addresses (Care Compare)

900 Walt Whitman Rd
Suite LL1
Melville, NY 11747-2215
Phone (516) 698-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Counselors of New York, LCSW, PLLC Clinical CurrentSince Jun 1, 2018 Accepting new patients

Locations

900 Walt Whitman Rd
Ste LL1
Melville, NY 11747
Phone (516) 698-5511

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.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1578056412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDFORD AVE STE 110",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721220",
            "telephone_number": "347-779-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDFORD AVE STE 110",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721220",
            "telephone_number": "473-779-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "JESSIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.