Jennie Lee Faraci, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083727 Issued in NY

Practice address

20 Hicksville Rd
Suite 5
Massapequa, NY 11758-5819

Phone

(631) 807-7937

NPI assigned

Jan 10, 2008

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 names 1

• Miss Jennie Lee Nicholas Former name

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1952587891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 MAPLE AVE",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117832933",
            "telephone_number": "631-807-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HICKSVILLE RD",
            "address_2": "SUITE 5",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585819",
            "telephone_number": "631-807-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARACI",
        "first_name": "JENNIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIE",
            "last_name": "NICHOLAS",
            "middle_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Salvatore Lawrence Fabbricante, D.D.S.
• John A Facchin, OD
• Michael Falkove, M.D.
• Family Dental Care of Massapequa P.C.
• Suzanne Nicole Fanelli, RPA-C
• Athena Faranda, LCSW
• Zohra Fariad, RPH
• Farrugia Neurology PC
• Teresa Farrugia, DO
• Christina Marie Fauci-Peranzo, OTR/L

• Clinical Social Worker in Massapequa, NY
• Providers in Massapequa, 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 May 2, 2016; 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.