Individual provider Active NPI

Jaymee Lauren Somberg, LCSW

  • Clinical Social Worker
  • New City, NY
National Provider Identifier
1811256613
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078802 Issued in NY
Practice address
100 Phillips Hill Rd
New City, NY 10956-4134
Phone
(646) 463-2013
Fax
(607) 203-5559
NPI assigned
May 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 078802 NY Primary

Addresses

Primary practice location

100 Phillips Hill Rd
New City, NY 10956-4134

Mailing address

100 Phillips Hill Rd
New City, NY 10956-4134
Phone (646) 463-2013

Other identifiers 1

IdentifierTypeStateIssuer
078802OtherNYNYS LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Simplepractice.com Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
078802NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1811256613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS HILL RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564134",
            "telephone_number": "646-463-2013",
            "fax_number": "607-203-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS HILL RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564134",
            "telephone_number": "646-463-2013",
            "fax_number": "607-203-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMBERG",
        "first_name": "JAYMEE",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "078802",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Simplepractice.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "100 Phillips Hill Rd",
            "city": "New City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109564134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.