Individual provider Active NPI

Jacqueline Marie Vicente, LMSW

  • Social Worker
  • Astoria, NY
National Provider Identifier
1285124008
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
103353-1 Issued in NY
Practice address
2041 47TH St FL 1
Astoria, NY 11105-1201
Phone
(707) 515-9205
NPI assigned
May 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 103353-1 NY Primary

Addresses

Primary practice location

2041 47TH St FL 1
Astoria, NY 11105-1201

Mailing address

2041 47TH St FL 1
Astoria, NY 11105-1201
Phone (707) 515-9205

Other names 1

  • Ms. Jacqueline Marie Oregel Former name

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
103353-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1285124008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 47TH ST FL 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051201",
            "telephone_number": "707-515-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 47TH ST FL 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051201",
            "telephone_number": "707-515-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENTE",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-17",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "103353-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "OREGEL",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.