Jill Brown, LCSW-R
Individual provider Active NPI Clinical Social Worker · Bohemia, NY
NPI 1861765356 · NPPES record last updated Feb 15, 2012
Key facts
- NPI
- 1861765356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- R045241-1 (NY)
- Practice address
- 193 Central Ave
Bohemia, NY 11716-3108 - Phone
- (631) 567-1640
- NPI assigned
- Feb 15, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1992
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
193 Central Ave
Bohemia, NY 11716-3108
Phone (631) 235-8577
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120320000193 | NY | Practitioner - Clinical Social Worker | 6507026143 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R045241-1 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Go Forward Psychotherapy LCSW-R PLLC | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R045241-1 | NY | Yes |
Addresses
Primary practice location
193 Central Ave
Bohemia, NY 11716-3108
Mailing address
193 Central Ave
Bohemia, NY 11716-3108
Phone (631) 567-1640
Other providers in Bohemia, NY
- Amy Bouziotis
- Nancy Lynn Bowden
- Jessica Breitweg
- Bright Bay Medical PLLC
- Brookview Medical Associates, PLLC
- Kaitlyn F Brown
- Jennifer L Bruno
- Nydia Esther Burgos
- Cheryl R Buscaglia
- Anthony Frank Buscaino
All providers in Bohemia, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.