Jerry Frank Maiello Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR024915-1 Issued in NY

Practice address

331 Ushers Road
Northway 10 Professional Park
Ballston Lake, NY 12019

Phone

(518) 371-1122

Fax

(518) 437-6565

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jerry Frank Maiello Jr. Professional name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124053897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO. BOX 873",
            "address_2": "CLIFTON PARK",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "120655013",
            "telephone_number": "518-371-1122",
            "fax_number": "518-437-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 USHERS ROAD",
            "address_2": "NORTHWAY 10 PROFESSIONAL PARK",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "12019",
            "telephone_number": "518-371-1122",
            "fax_number": "518-437-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIELLO",
        "first_name": "JERRY",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR024915-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "MAIELLO",
            "middle_name": "FRANK",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Terri Anne Lefever, PA-C
• Vera A Legnard
• Lincare Inc
• Susan J Little, RPN
• Beth Anne Locatelli
• Kelly S Malloch, LMSW
• Zoriana N. Mangione
• Morgan D Marruso
• Felix Luis Martinez Jr., LMSW
• Julissa Martinez, LMHC-D, NCC, CASAC

• Clinical Social Worker in Ballston Lake, NY
• Providers in Ballston Lake, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.