Active NPI
Jennae Phillippe
- Social Worker
- Brooklyn, NY
National Provider Identifier
1700330164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 085287
- Practice address
- 830 Putnam Ave Apt 2a
Brooklyn, NY 11221-5535 - Phone
- (856) 441-3876
- NPI assigned
- Aug 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 085287 | NY | Primary |
Addresses
Primary practice location
830 Putnam Ave Apt 2a
Brooklyn, NY 11221-5535
Mailing address
830 Putnam Ave Apt 2a
Brooklyn, NY 11221-5535
Phone (718) 788-2461
Other practice location 1
348 13th St
Suite 503
Brooklyn, NY 11215-6177
Phone (718) 788-2461
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085287 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Slope Center for Mental Health, Inc | Current | Accepting new patients |
Locations
348 13th St
Ste 203
Brooklyn, NY 11215
Phone (718) 788-5101
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Brooklyn, NY
- NPI 1851382188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1700330164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 PUTNAM AVE APT 2A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112215535",
"telephone_number": "718-788-2461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 PUTNAM AVE APT 2A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112215535",
"telephone_number": "856-441-3876"
}
],
"practiceLocations": [
{
"address_1": "348 13th St",
"address_2": "Suite 503",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112156177",
"country_code": "US",
"telephone_number": "718-788-2461",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHILLIPPE",
"first_name": "JENNAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "085287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.