Individual provider Active NPI

Jean Langan Behrens, LCSW

  • Clinical Social Worker
  • Bellport, NY
National Provider Identifier
1801929385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R043644-1 Issued in NY
Practice address
10 Station CT
Bellport, NY 11713-2453
Phone
(631) 286-5723
Fax
(631) 286-5723
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R043644-1 NY Primary

Addresses

Primary practice location

10 Station CT
Bellport, NY 11713-2453

Mailing address

10 Station CT
Bellport, NY 11713-2453
Phone (631) 286-5723

Other identifiers 1

IdentifierTypeStateIssuer
163925OtherNYVALUE OPTIONS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080728000704 NY Practitioner - Clinical Social Worker 9032283858 Reassigns benefits to 1 organization
Practice locations: East Patchogue, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R043644-1NYMDClinical Social Worker
043644NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookhaven Memorial Hospital Medical Center, Inc. Current Accepting new patients
Long Island Community Hospital at NYU Langone Health CurrentSince Jul 18, 2017 Accepting new patients
Brookhaven Memorial Hospital Medical Center, Inc. CurrentSince Jul 18, 2017 Accepting new patients

Locations

365 E Montauk Hwy
Patchogue, NY 11772
Phone (631) 654-7370

550 Montauk Hwy
Shirley, NY 11967
Phone (631) 852-1000

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

198 Roseland LN
East Patchogue, NY 11772-6238
Phone (631) 286-5723

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801929385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 STATION CT",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132453",
            "telephone_number": "631-286-5723",
            "fax_number": "631-286-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STATION CT",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132453",
            "telephone_number": "631-286-5723",
            "fax_number": "631-286-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "JEAN",
        "middle_name": "LANGAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R043644-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "163925",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellport, NY

Sources for this page

Verify at the official NPI Registry.