JESSICA DETOR LMSW
NPI 1164989505
Social Worker - Clinical in Syracuse, NY

Active since February 21, 2019
4900 BROAD RD, PHYSICIAN OFFICE BUILDING NORTH 3N, SYRACUSE, NY 13215(315) 949-1031 Get Directions Write a Review

NPPES record last updated: February 21, 2019. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Jessica Detor Lmsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA DETOR LMSW (NPI 1164989505) is an individual clinical provider in Syracuse, New York, licensed in New York (068827) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1164989505
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJESSICA DETORCredential: LMSW
Location Address4900 BROAD RD, PHYSICIAN OFFICE BUILDING NORTH 3NSyracuse, NY 13215-2265
Mailing Address4900 Broad Rd, Pob North 3nSyracuse, NY 13215-2265
Sole ProprietorNo
Enumeration DateFebruary 21, 2019
NPI 1164989505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in NY · 068827
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4900 BROAD RD, Syracuse, NY 13215

Other Names 1

Former Name (1)Jessica Camp Lcsw

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Practitioner (Family)
4900 BROAD RD, SUITE 4K
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Psychiatry & Neurology (Neurology)
4900 BROAD RD, CGH POB SUITE 2F
SYRACUSE, NY 13215
Physician Assistant
4900 BROAD RD
SYRACUSE, NY 13215

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Detor's NPI number?

The NPI number for Jessica Detor is 1164989505. It was assigned to this individual provider in the NPPES registry on February 21, 2019. The provider is also known as Jessica Camp Lcsw.

Where is Jessica Detor located?

Jessica Detor practices at 4900 Broad Rd Physician Office Building North 3N, Syracuse, NY 13215. The listed phone number is (315) 949-1031.

What is Jessica Detor's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jessica Detor was last updated on February 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.