Jennifer Donnelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096849 Issued in NY

Practice address

78 Fox CT
Manorville, NY 11949-2614

Phone

(631) 603-8715

NPI assigned

May 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Wilson Former name

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrity Social Work Services LLCGroup PAC ID 4880609528, 74 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Integrity Social Work Services LLC

  • Mental Health Counselor
  • Staten Island, NY
  • NPI 1972715456

  Clinical

  Medicare reassignment Care Compare group NPD
• Shine Medical PC

  • Psychiatry Physician
  • New York, NY
  • NPI 1427783950
  NPD (past)
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1194832477
  NPD (past)

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1811635659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 FOX CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492614",
            "telephone_number": "631-603-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 FOX CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492614",
            "telephone_number": "631-603-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "061999",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WILSON",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anthony Destefano
• Juliana Marissa Devito
• Julie A. Diers, LBA, LCSW
• James Dinapoli, DPM
• Alice Domino
• James L Earl, FNP-C
• East End Gastroenterology PLLC
• Eastport South Manor Central School District
• Eastport South Manor School District
• Katelyn Edwards

• Clinical Social Worker in Manorville, NY
• Providers in Manorville, 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 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.