MEDICARE: JAMIE HELLEN OYATHELEMI LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	0971171	NY
2	104100000X	Social Worker	097630	NY

General Provider Information

NPI Number	:	1255860920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE HELLEN OYATHELEMI LCSW

Provider Business Mailing Address
First Line	:	1908 BROOKHAVEN AVE
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3626
Country	:	US
Telephone Number	:	718-869-8400
Fax Number	:	844-310-8401

Provider Business Practice Location Address
First Line	:	1908 BROOKHAVEN AVE
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3626
Country	:	US
Telephone Number	:	718-869-8400
Fax Number	:	844-310-8401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	04/21/2025

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