Jenna Jean Martuscello, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

112693 Issued in NY

Practice address

7555 Main Rd
Mattituck, NY 11952-1516

Phone

(631) 298-8642

NPI assigned

Oct 27, 2021

Last updated

Oct 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1639833502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 BUNGALOW LN",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119522282",
            "telephone_number": "631-903-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521516",
            "telephone_number": "631-298-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTUSCELLO",
        "first_name": "JENNA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "112693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Mattituck, NY
• Providers in Mattituck, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.