Jenny G Pourakis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05238600 Issued in NJ

Practice address

192 3Rd Ave
Suite 12
Westwood, NJ 07675-2154

Phone

(201) 421-7371

NPI assigned

Jun 19, 2012

Last updated

Jun 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1912260670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 SARGENT RD",
            "city": "RIVERVALE",
            "state": "NJ",
            "postal_code": "076756540",
            "telephone_number": "201-421-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 3RD AVE",
            "address_2": "SUITE 12",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752154",
            "telephone_number": "201-421-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURAKIS",
        "first_name": "JENNY",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05238600",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071679-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Paul Aaron Possick, MD
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• Progressive Hand Therapy, LLC
• Brianna Puccio

• Clinical Social Worker in Westwood, NJ
• Providers in Westwood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.