1487694907 NPI number — JEANNE G. HALPERN-LEWIS, LCSW. PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487694907 NPI number — JEANNE G. HALPERN-LEWIS, LCSW. PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEANNE G. HALPERN-LEWIS, LCSW. PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487694907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
79 RIVER HEIGHTS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SMITHTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11787-1754
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-265-4920
Provider Business Mailing Address Fax Number:
631-265-4920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79 RIVER HEIGHTS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMITHTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11787-1754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-265-4920
Provider Business Practice Location Address Fax Number:
631-265-4920
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HALPERN-LEWIS
Authorized Official First Name:
JEANNE
Authorized Official Middle Name:
GAIL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
631-265-4920

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R047181-01 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2107149 . This is a "CIGNA INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: NG3811 . This is a "EMPIRE-MAGELLAN B HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1999676 . This is a "OXFORD INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 120779 . This is a "VYTRA INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: R047181 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 315803 . This is a "MHN INSURANCE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7352224 . This is a "EMPIRE-VALUEOPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02261296 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 141486 . This is a "VALUEOPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7352224 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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