Individual provider Active NPI

Jerome R Wile, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1891806691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R023769 Issued in NY
Practice address
33 Greenwich Ave
Suite 2D
New York, NY 10014-2701
Phone
(212) 255-5075
Fax
(212) 255-4937
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R023769 NY Primary

Addresses

Primary practice location

33 Greenwich Ave
Suite 2D
New York, NY 10014-2701

Mailing address

33 Greenwich Ave
Suite 2D
New York, NY 10014-2701
Phone (212) 255-5075

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
023769NYMDPsychologist
R023769NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891806691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GREENWICH AVE",
            "address_2": "SUITE 2D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100142701",
            "telephone_number": "212-255-5075",
            "fax_number": "212-255-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 GREENWICH AVE",
            "address_2": "SUITE 2D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100142701",
            "telephone_number": "212-255-5075",
            "fax_number": "212-255-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILE",
        "first_name": "JEROME",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R023769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, 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.

Verify at the official NPI Registry.