Individual provider Active NPI

Janan Virginia Furlong, LCSW

  • Clinical Social Worker
  • Port Jervis, NY
National Provider Identifier
1689215352
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097001-01 Issued in NY
Practice address
146 Pike St
Port Jervis, NY 12771-1808
Phone
(845) 858-1456
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37429 NY
Clinical Social Worker 1041C0700X 097001-01 NY Primary

Addresses

Primary practice location

146 Pike St
Port Jervis, NY 12771-1808

Mailing address

44 W Peenpack TRL
Sparrow Bush, NY 12780-5003
Phone (845) 707-1049

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
I20240507002372 NY Practitioner - Clinical Social Worker 6002257110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of OrangeGroup PAC ID 0648169185, 28 clinicians

Practice addresses (Care Compare)

146 Pike St
Port Jervis, NY 12771-1808
Phone (845) 856-1458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37429NYMDAddiction (Substance Use Disorder) Counselor
097001-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange CurrentSince Apr 1, 2024 Accepting new patients
County of Orange CurrentSince Apr 1, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

30 Harriman Dr
Goshen, NY 10924
Phone (845) 291-2600

146 Pike St
Port Jervis, NY 12771
Phone (845) 856-1458

Organizations & group practices 3

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": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1689215352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W PEENPACK TRL",
            "city": "SPARROW BUSH",
            "state": "NY",
            "postal_code": "127805003",
            "telephone_number": "845-707-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711808",
            "telephone_number": "845-858-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURLONG",
        "first_name": "JANAN",
        "middle_name": "VIRGINIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "37429",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097001-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

Sources for this page

Verify at the official NPI Registry.