Individual provider Active NPI

Jackeline E Muniz-Marrero, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1063091080
Registry record updated Jul 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090766 Issued in NY
Practice address
111 E 21St St
Brooklyn, NY 11226-3062
Phone
(718) 594-4254
NPI assigned
Apr 6, 2021
Last updated
Jul 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NY
Clinical Social Worker 1041C0700X 090766 NY Primary

Addresses

Primary practice location

111 E 21St St
Brooklyn, NY 11226-3062

Mailing address

111 E 21St St Apt F9
Brooklyn, NY 11226-3060
Phone (718) 594-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
090766NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752883200000",
    "number": "1063091080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 21ST ST APT F9",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263060",
            "telephone_number": "718-594-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 21ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112263062",
            "telephone_number": "718-594-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZ-MARRERO",
        "first_name": "JACKELINE",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.