Active NPI
Jacqueline A Gantnier, LCSW
- Clinical Social Worker
- Ellenville, NY
National Provider Identifier
1881764074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 072946
- Practice address
- 50 Center St
Ellenville, NY 12428-1315 - Phone
- (845) 647-3266
- Fax
- (845) 647-1103
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 072946 | NY | Primary |
Addresses
Primary practice location
50 Center St
Ellenville, NY 12428-1315
Mailing address
345 Tow Path Rd
Accord, NY 12404-5522
Phone (845) 687-0636
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
| License | State | Type | Specialty |
|---|---|---|---|
| 072946 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881764074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 TOW PATH RD",
"city": "ACCORD",
"state": "NY",
"postal_code": "124045522",
"telephone_number": "845-687-0636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 CENTER ST",
"city": "ELLENVILLE",
"state": "NY",
"postal_code": "124281315",
"telephone_number": "845-647-3266",
"fax_number": "845-647-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANTNIER",
"first_name": "JACQUELINE",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "072946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ellenville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.