Individual provider Active NPI

Joanne R. McKernan, LCSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1871804070
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071301 Issued in NY
Practice address
14 Slosson Ter
Staten Island, NY 10301-2507
Phone
(718) 720-6727
Fax
(718) 720-0326
NPI assigned
Jun 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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 071301 NY Primary

Addresses

Primary practice location

14 Slosson Ter
Staten Island, NY 10301-2507

Mailing address

14 Slosson Ter
Staten Island, NY 10301-2507
Phone (718) 720-6727

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
071301NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Medical Services, P.C. Past Accepting new patients

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1871804070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SLOSSON TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012507",
            "telephone_number": "718-720-6727",
            "fax_number": "718-720-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 SLOSSON TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012507",
            "telephone_number": "718-720-6727",
            "fax_number": "718-720-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "JOANNE",
        "middle_name": "R.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.