Individual provider Active NPI

Jeremy Mauro, LCSW

  • Clinical Social Worker
  • Dunkirk, NY
National Provider Identifier
1174979363
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
095247-01 Issued in NY
Practice address
75 E 3Rd St
Dunkirk, NY 14048-2239
Phone
(716) 363-6050
NPI assigned
May 6, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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 095247-01 NY Primary
Social Worker 104100000X 097482-1 NY

Addresses

Primary practice location

75 E 3Rd St
Dunkirk, NY 14048-2239

Mailing address

265 Union St Ste 104
Hamburg, NY 14075-4755
Phone (716) 562-6075

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
097482-1NYMDSocial Worker
095247-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1174979363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 UNION ST STE 104",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754755",
            "telephone_number": "716-562-6075",
            "fax_number": "716-648-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E 3RD ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482239",
            "telephone_number": "716-363-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "JEREMY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095247-01",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097482-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.