Jessica Lyn Haddad, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11414601 Issued in NY

Practice address

600 Mamaroneck Ave Ste 478
Harrison, NY 10528-1635

Phone

(888) 604-6776

NPI assigned

Dec 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 21, 2025 through Feb 21, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Counseling Center Group, LLC

  • Clinical Social Worker
  • Red Bank, NJ
  • NPI 1700649894
  NPD

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1821756065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAMARONECK AVE STE 478",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281635",
            "telephone_number": "888-604-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAMARONECK AVE STE 478",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281635",
            "telephone_number": "888-604-6776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 Lexington Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100160941",
            "country_code": "US",
            "telephone_number": "888-604-6776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "28091",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "11414601",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06688200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica@ccgrouptherapy.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA secure gmail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "353 Lexington Ave Ste 310",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100160941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan M Gunderson, SLP
• Lisa Helen Gussack, RN CNM
• Triny Gutierrez, DMD, MS
• Angel Minnike Guy, CRNA
• Madison Lane Haberman, PHYSICIAN ASSISTANT
• Helen Teresa Hanning Arena, PH.D.
• Dean B Harlam, M.D.
• Ryan Michael Harrington, MD
• Harrison Central School District
• Harrison Chiropractic PC

• Clinical Social Worker in Harrison, NY
• Providers in Harrison, 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 Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.