Jacqueline Blatt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO327041 Issued in NY

Practice address

47 Humphrey Dr
Syosset, NY 11791-4022

Phone

(516) 921-7171

Fax

(516) 496-4958

NPI assigned

Jan 8, 2010

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

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Living Behavioral Health LCSW PLLCGroup PAC ID 9931482247, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Senior Living Behavioral Health LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1083150056
  Medicare reassignment Care Compare group NPD
• Long Island Elder Care LCSW PLLC

  • Social Worker
  • Smithtown, NY
  • NPI 1295763852
  Medicare reassignment NPD
• Senior Living Behavioral Health, PLLC

  • Clinical Social Worker
  • Panama City Beach, FL
  • NPI 1346721917
  NPD (past)

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1679803969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CENTRAL DR",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451107",
            "telephone_number": "516-674-2141",
            "fax_number": "516-674-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 HUMPHREY DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914022",
            "telephone_number": "516-921-7171",
            "fax_number": "516-496-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATT",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO327041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashleigh Bieder
• Andrew Bier
• Rose Beatrice Bishop, LCSW R
• Terese P Bitner, M.ED, T.S.H.H.
• Shernice Jenell Blackman
• Kyla Josie Blattberg, PH.D.
• Sherry Joy Bloom, FNP
• Jodi Bloomgarden, MS, CCC/SLP
• Virginia Blum
• Nina Blumenfeld, LCSW

• Clinical Social Worker in Syosset, NY
• Providers in Syosset, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.