Active NPI
Jatia Peterson, LMSW
- Social Worker
- Syracuse, NY
National Provider Identifier
1972840114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 088378
- Practice address
- 620 Erie Blvd W
Suite 208
Syracuse, NY 13204-2445 - Phone
- (315) 472-7363
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 088378 | NY | Primary |
Addresses
Primary practice location
620 Erie Blvd W
Suite 208
Syracuse, NY 13204-2445
Mailing address
620 Erie Blvd W
Suite 208
Syracuse, NY 13204-2445
Phone (315) 472-7363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 088378 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onondaga Case Management Services Inc. | Social Worker | Past | Accepting new patients |
| Onondaga Case Management Services Inc. | Past | Accepting new patients |
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.
-
- Case Management Agency
- Syracuse, NY
- NPI 1235184235
Social Worker
-
- Adult Mental Health Clinic/Center
- Syracuse, NY
- NPI 1497252563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1972840114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 ERIE BLVD W",
"address_2": "SUITE 208",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132042445",
"telephone_number": "315-472-7363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 ERIE BLVD W",
"address_2": "SUITE 208",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132042445",
"telephone_number": "315-472-7363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JATIA",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "088378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.