Jackqueline Anne Merulla, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083923-1 Issued in NY

Practice address

404 Oak Street Street
Suite 200
Syracuse, NY 13203-2997

Phone

(315) 703-0168

Fax

(315) 299-2530

NPI assigned

Aug 25, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jackqueline Merulla Bramhall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wellness Therapy Services LCSW, PLLC

  • Mental Health Counselor
  • Syracuse, NY
  • NPI 1215405287
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1043590730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 OAK STREET STREET",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032997",
            "telephone_number": "315-703-0168",
            "fax_number": "315-299-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 OAK STREET STREET",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032997",
            "telephone_number": "315-703-0168",
            "fax_number": "315-299-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERULLA",
        "first_name": "JACKQUELINE",
        "middle_name": "ANNE",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083923-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKQUELINE",
            "last_name": "BRAMHALL",
            "middle_name": "MERULLA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven Merrill, DO
• Marsha A. Merriweather, CASAC
• Desiree Mersfelder
• Devin Mertens
• David Mertz
• Mesa of N.Y., Inc.
• Michael Mesa, MHC-LP
• Jacob Mesches, MD, MS
• Alexis Rae Messak, NP
• Stacey L Messe, RD, CDN, CNSC

• Clinical Social Worker in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.