Individual provider Active NPI

Jean Clanahan Winne, LCSW/R

  • Clinical Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1811269475
Registry record updated Jan 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R041063 Issued in NY
Practice address
25 Wilson Blvd
Poughkeepsie, NY 12603-3303
Phone
(914) 489-2268
NPI assigned
Jan 29, 2012
Last updated
Jan 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2012

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 R041063 NY Primary

Addresses

Primary practice location

25 Wilson Blvd
Poughkeepsie, NY 12603-3303

Mailing address

25 Wilson Blvd
Poughkeepsie, NY 12603-3303
Phone (914) 489-2268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20230614003872 VA Practitioner - Clinical Social Worker 1557344835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old Towne Counseling Services LLCGroup PAC ID 7618149865, 28 clinicians

Practice addresses (Care Compare)

7489 Right Flank Rd
Suite 330
Mechanicsville, VA 23116-3845
Phone (804) 398-8401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R041063NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Old Towne Counseling Services, LLC CurrentSince May 5, 2023 Accepting new patients

Locations

7489 Right Flank Rd
Ste 330
Mechanicsvlle, VA 23116

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1327795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327795200000",
    "number": "1811269475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WILSON BLVD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033303",
            "telephone_number": "914-489-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WILSON BLVD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033303",
            "telephone_number": "914-489-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNE",
        "first_name": "JEAN",
        "middle_name": "CLANAHAN",
        "credential": "LCSW/R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-29",
        "last_updated": "2012-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R041063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.