Active NPI
Jessica Giambra, LCSW
- Clinical Social Worker
- Kennett Square, PA
National Provider Identifier
1700280237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW019559
- Practice address
- 500 Orchard Ave
Suite 202
Kennett Square, PA 19348-1812 - Phone
- (201) 491-4896
- Fax
- (484) 731-9069
- NPI assigned
- Oct 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9403 | PA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1540 | DE | |
| Social Worker | 104100000X | SW130638 | PA | |
| Social Worker | 104100000X | 44SL05857700 | NJ | |
| Clinical Social Worker | 1041C0700X | CW019559 | PA | Primary |
Addresses
Primary practice location
500 Orchard Ave
Suite 202
Kennett Square, PA 19348-1812
Mailing address
500 Orchard Ave
Suite 202
Kennett Square, PA 19348-1812
Phone (201) 491-4896
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1540 | DE | MD | Addiction (Substance Use Disorder) Counselor |
| 9403 | PA | MD | Addiction (Substance Use Disorder) Counselor |
| 44SL05857700 | NJ | MD | Social Worker |
| SW130638 | PA | MD | Social Worker |
| CW019559 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1700280237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 ORCHARD AVE",
"address_2": "SUITE 202",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193481812",
"telephone_number": "201-491-4896",
"fax_number": "484-731-9069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 ORCHARD AVE",
"address_2": "SUITE 202",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193481812",
"telephone_number": "201-491-4896",
"fax_number": "484-731-9069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIAMBRA",
"first_name": "JESSICA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-13",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "PA",
"license": "9403",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "DE",
"license": "1540",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW130638",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05857700",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW019559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennett Square, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.