Individual provider Active NPI

Jennifer Spellicy, LMSW

  • Social Worker
  • Lowville, NY
National Provider Identifier
1861941973
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
098676 Issued in NY
Practice address
7550 S State St
Lowville, NY 13367-1574
Phone
(315) 376-5450
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 098676 NY Primary

Addresses

Primary practice location

7550 S State St
Lowville, NY 13367-1574

Mailing address

482 Black River Pkwy
Watertown, NY 13601-2416
Phone (315) 782-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
098676NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Transitional Living Services, Inc PastSince Jul 1, 2019 Accepting new patients
Thrive Wellness and Recovery, Inc PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 2

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": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1861941973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 BLACK RIVER PKWY",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012416",
            "telephone_number": "315-782-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 S STATE ST",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671574",
            "telephone_number": "315-376-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLICY",
        "first_name": "JENNIFER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "098676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.