Dorothy W Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

057832 Issued in NY

Practice address

1076 Main St
Suite 203
Fishkill, NY 12524-3606

Phone

(203) 521-4747

Fax

(845) 728-0667

NPI assigned

Jun 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Paula Kay Kermani NP - Psychiatry PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fishkill, NY
  • NPI 1518383033
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1942521539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MYERS CORNERS RD",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125902219",
            "telephone_number": "203-521-4747",
            "fax_number": "845-728-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 MAIN ST",
            "address_2": "SUITE 203",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125243606",
            "telephone_number": "203-521-4747",
            "fax_number": "845-728-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DOROTHY",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "057832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03308647",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leandra Carmen Infante, LMSW
• Integrated Health Solutions, Inc.
• Lyssa Irizarry, MSPED
• J Bieber Oral and Maxillofacial Surgery PLLC
• Anna Jabbour, PHARM.D.
• Jenee Jackson
• David Samuel Jacobs, M.D.
• Steven Kenneth Jacobs, M.D.
• Lasha Jaiani, M.D.
• Shevanie Latchmi Jallim, OD

• Clinical Social Worker in Fishkill, NY
• Providers in Fishkill, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.