Healthcare Provider Details

I. General information

NPI: 1578156907
Provider Name (Legal Business Name): JESSICA D FILPO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAIN ST
OSSINING NY
10562-4702
US

IV. Provider business mailing address

1 ALEXANDER ST APT 107
YONKERS NY
10701-7561
US

V. Phone/Fax

Practice location:
  • Phone: 914-488-6131
  • Fax:
Mailing address:
  • Phone: 646-280-9671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number100279
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095115
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100279
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: