Active NPI
Jenevieve Marguerite Kearns, LMSW
- Clinical Social Worker
- Dix Hills, NY
National Provider Identifier
1801037502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 077402
- Practice address
- 151 Burrs LN
Dix Hills, NY 11746-6052 - Phone
- (631) 643-8800
- Fax
- (631) 491-4440
- NPI assigned
- Mar 10, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 077402 | NY | Primary |
Addresses
Primary practice location
151 Burrs LN
Dix Hills, NY 11746-6052
Mailing address
377 Baldwin Path
Deer Park, NY 11729-1414
Phone (631) 987-4601
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 |
|---|---|---|---|
| 077402 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sco Family of Services Dba Madonna Heights Service Clinic | Past | Accepting new patients | |
| Samaritan Pediatric Services, P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
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- Babylon, NY
- NPI 1730308925
-
- Physical Disabilities Residential Treatment Facility
- Garden City, NY
- NPI 1992801062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236643200000",
"number": "1801037502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 BALDWIN PATH",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117291414",
"telephone_number": "631-987-4601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 BURRS LN",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117466052",
"telephone_number": "631-643-8800",
"fax_number": "631-491-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEARNS",
"first_name": "JENEVIEVE",
"middle_name": "MARGUERITE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-10",
"last_updated": "2009-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "077402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dix Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.