Jessica Dawn Whitmore
Individual provider Active NPI Social Worker · Black River, NY
NPI 1801445986 · NPPES record last updated Sep 10, 2019
Key facts
- NPI
- 1801445986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 121 N Main St
Black River, NY 13612-2109 - Phone
- (315) 955-4662
- NPI assigned
- Sep 10, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200707002336 | NY | Order and Referring Only - Clinical Social Worker | 3173946308 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bobbi L Petranchuk LCSW PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | NY | Yes |
Addresses
Primary practice location
121 N Main St
Black River, NY 13612-2109
Mailing address
121 N Main St
Black River, NY 13612-2109
Phone (315) 955-4662
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | JessicaWhitmoreCounseling@gmail.com | ||
| CONNECT URL | JessicaWhitmoreCounseling@gmail.com |
Other providers in Black River, NY
- Anmmarie Tweedy Palmer
- Tammy Kelsey Perez
- Samantha Ann Schirmer
- Vincent a. Cesario DMD LLC
- Hans Werner Wawrousek Jr.
All providers in Black River, NY · Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.