Jaclyn Priscilla Slate, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

955332 Issued in NY

Practice address

1003 Park St
Ogdensburg, NY 13669-3911

Phone

(315) 713-9090

Fax

(315) 713-9330

NPI assigned

Jun 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jaclyn Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Citizen Advocates, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  NPD
• North Country Transitional Living Services, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Watertown, NY
  • NPI 1538294699
  NPD
• Thrive Wellness and Recovery, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Watertown, NY
  • NPI 1659389021
  NPD

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1922624667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 BLACK RIVER PKWY",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012416",
            "telephone_number": "315-782-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PARK ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693911",
            "telephone_number": "315-713-9090",
            "fax_number": "315-713-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "482 Black River Pkwy",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136012416",
            "country_code": "US",
            "telephone_number": "315-782-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATE",
        "first_name": "JACLYN",
        "middle_name": "PRISCILLA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106707",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "955332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SMITH",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sherry Lynn Simon, RN
• Lauren Michelle Simons, LMSW
• Rachael Beth Simons, RN
• Kristin Ann Simpson, LMSW
• Sandeep Sirsi, MD
• Eldin Smajkan, OD
• Evan Nels Smeby, RN
• Edward D Smith, DDS
• Julie Lynn Smith, REGISTERED NURSE
• Katelyn R Smith, RN

• Registered Nurse in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.