Individual provider Active NPI

Jennifer Lee Pignataro, LCSW

  • Clinical Social Worker
  • Campbell Hall, NY
National Provider Identifier
1922432897
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093894 Issued in NY
Practice address
18 Erie St
Campbell Hall, NY 10916-2702
Phone
(845) 542-1079
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093894 NY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

18 Erie St
Campbell Hall, NY 10916-2702

Mailing address

18 Erie St
Campbell Hall, NY 10916-2702
Phone (845) 542-1079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103003068 NY Practitioner - Clinical Social Worker 6406206499 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
093894NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Clinical CurrentSince Nov 11, 2023 Accepting new patients
Catholic Charities of Orange, Sullivan & Ulster Past Accepting new patients

Locations

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

98120 Queens Blvd
Ste 1C
Rego Park, NY 11374
Phone (718) 268-9598

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1922432897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ERIE ST",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162702",
            "telephone_number": "845-542-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 ERIE ST",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162702",
            "telephone_number": "845-542-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIGNATARO",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2023-03-13",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093894",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell Hall, NY

Sources for this page

Verify at the official NPI Registry.