Individual provider Active NPI

Jeffrey Jin, LSW

  • Social Worker
  • Voorhees, NJ
National Provider Identifier
1710317508
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL05158500 Issued in NJ
Practice address
201 Laurel Oak Rd
Suite a
Voorhees, NJ 08043-4424
Phone
(856) 566-5467
Fax
(856) 782-2046
NPI assigned
Nov 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL05158500 NJ Primary

Addresses

Primary practice location

201 Laurel Oak Rd
Suite a
Voorhees, NJ 08043-4424

Mailing address

1002 Gregorys Way
Voorhees, NJ 08043-2058
Phone (856) 651-0822

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

LicenseStateTypeSpecialty
44SL05158500NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1710317508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 GREGORYS WAY",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432058",
            "telephone_number": "856-651-0822",
            "fax_number": "856-782-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAUREL OAK RD",
            "address_2": "SUITE A",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434424",
            "telephone_number": "856-566-5467",
            "fax_number": "856-782-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05158500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.