Individual provider Active NPI

Jackie Lynn Sweeney, LMSW

  • Social Worker
  • Central Islip, NY
National Provider Identifier
1841752615
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
106177 Issued in NY
Practice address
320 Carleton Ave
Central Islip, NY 11722-4506
Phone
(631) 663-4300
NPI assigned
Apr 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 106177-1 NY
Social Worker 104100000X 106177 NY Primary

Addresses

Primary practice location

320 Carleton Ave
Central Islip, NY 11722-4506

Mailing address

23 Carleton Ave
Central Islip, NY 11722
Phone (631) 663-4300

Other names 1

  • Jackie Lynn Warner Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240304003599 NY Practitioner - Clinical Social Worker 5597100271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service League IncGroup PAC ID 4284524448, 47 clinicians

Practice addresses (Care Compare)

7555 Main Rd
Mattituck, NY 11952-1516
Phone (631) 298-8642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106177NYMDSocial Worker
106177-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Jan 10, 2024 Accepting new patients

Locations

320 Carleton Ave
Central Islip, NY 11722
Phone (631) 234-7807

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

7555 Main Rd
Mattituck, NY 11952
Phone (631) 298-1678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1841752615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "11722",
            "telephone_number": "631-663-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224506",
            "telephone_number": "631-663-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "JACKIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106177-1",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "WARNER",
            "middle_name": "LYNN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Central Islip, NY

Sources for this page

Verify at the official NPI Registry.