Jennifer K Baccile, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096273 Issued in NY

Practice address

100 Washington St
Elmira, NY 14901-2849

Phone

(607) 737-4882

NPI assigned

Jan 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1811405459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 SOUTHPORT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149042136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149012849",
            "telephone_number": "607-737-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCILE",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kali Renee Ayaz
• Basem Nady Azab, M.D.
• Faris Aziz
• Tolulope Abiola Babalola, MD
• Patricia A Babcock, NPP
• Kristen Canfield Bacon, OTD, MS, OTR/L
• William Joseph Bacon, RPH
• Charles Junior Badger II, MD
• Mary R Bado, LCSWR
• Arnab K. Bagchi, LCSW-R

• Clinical Social Worker in Elmira, NY
• Providers in Elmira, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.