Individual provider Active NPI

Jamesa Staten

  • Clinical Social Worker
  • White Plains, NY
National Provider Identifier
1639685449
Registry record updated Feb 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088629 Issued in NY
Practice address
1 Martine Ave Apt 308
White Plains, NY 10606-4605
Phone
(718) 710-8023
NPI assigned
Dec 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 25459 MD
Social Worker 104100000X 092571 NY
Clinical Social Worker 1041C0700X 088629 NY Primary

Addresses

Primary practice location

1 Martine Ave Apt 308
White Plains, NY 10606-4605

Mailing address

1 Martine Ave Apt 308
White Plains, NY 10606-4605
Phone (718) 710-8023

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

LicenseStateTypeSpecialty
092571NYMDSocial Worker
25459MDMDClinical Social Worker
088629NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1513468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1639685449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MARTINE AVE APT 308",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106064605",
            "telephone_number": "718-710-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARTINE AVE APT 308",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106064605",
            "telephone_number": "718-710-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "JAMESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-17",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25459",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092571",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2022; 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.