Jacqueline Jaffe O'Duor, LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

017676 Issued in PA

Legal business name

JACQUELINE JAFFE O'DUOR, LLC

Practice address

2305 Fairmount Ave
Philadelphia, PA 19130-2515

Phone

(267) 329-9393

NPI assigned

Mar 31, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline Jaffe O'Duor, LCSWNPI 1790033520

Title

Licensed Clinical Social Workr

Phone

(267) 329-9393

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Jaffe O'Duor, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1790033520
  NPD (past) Authorized official

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1639532237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 KINGSESSING AVE",
            "address_2": "SUITE 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191434327",
            "telephone_number": "267-329-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302515",
            "telephone_number": "267-329-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE JAFFE O'DUOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "O'DUOR",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "JAFFE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKR",
        "authorized_official_telephone_number": "267-329-9393",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "PA",
            "license": "017676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "12535207",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia R Jacobstein, M.D.
• Marin Jacobwitz
• Douglas Scott Jacoby
• Peter Harrison Jacoby, MD
• Christina Jacovides
• Carol J Jacques, MSW LCSW
• Guesthia Jacques, LMSW
• Natacha Jacques
• Michael Jacunski, DO
• Jeffery Jadczak, PT

• Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.