Individual provider Active NPI

Jennifer Tomlinson, LCSW R

  • Clinical Social Worker
  • Middletown, NY
National Provider Identifier
1831507870
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070756 Issued in NY
Practice address
45 Ashley Ave
Middletown, NY 10940-1912
Phone
(914) 261-4306
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 070756 NY Primary

Addresses

Primary practice location

45 Ashley Ave
Middletown, NY 10940-1912

Mailing address

184 Grange Rd
Otisville, NY 10963-3111
Phone (914) 261-4306

Other names 1

  • Jennifer Pavlicek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070756NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1831507870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 GRANGE RD",
            "city": "OTISVILLE",
            "state": "NY",
            "postal_code": "109633111",
            "telephone_number": "914-261-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ASHLEY AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401912",
            "telephone_number": "914-261-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLINSON",
        "first_name": "JENNIFER",
        "credential": "LCSW R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PAVLICEK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.