Jacob Abraham, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

102718 Issued in NY

Practice address

1519 Nye Rd
Lyons, NY 14489-9133

Phone

(315) 902-3100

NPI assigned

Aug 7, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1932939501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 NYE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 NYE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899133",
            "telephone_number": "315-902-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 E Dezeng St",
            "address_purpose": "LOCATION",
            "city": "Clyde",
            "state": "NY",
            "postal_code": "144339513",
            "country_code": "US",
            "telephone_number": "315-902-3100 x20144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Glasgow St",
            "address_purpose": "LOCATION",
            "city": "Clyde",
            "state": "NY",
            "postal_code": "144331222",
            "country_code": "US",
            "telephone_number": "315-923-2411 x5270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JACOB",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "102718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Abbott I, LCSW
• Elizabeth Abdo, LMSW
• Samantha Abiuso
• Odysseus Adamides Jr., M.D.
• John R Allard, MS IN ED
• Mary Pat Allen, FNP
• Joel C Archer
• James Joseph Arena, LCSW R

• Social Worker in Lyons, NY
• Providers in Lyons, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.