Individual provider Active NPI

Jacqueline Palladino, LCSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1346659398
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089377 Issued in NY
Practice address
161-10 Jamaica Ave
Jamaica, NY 11432
Phone
(718) 704-5488
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X 094430-1 NY
Clinical Social Worker 1041C0700X 089377 NY Primary

Addresses

Primary practice location

161-10 Jamaica Ave
Jamaica, NY 11432

Mailing address

161-10 Jamaica Ave
Jamaica, NY 11432

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200806002038 NY Practitioner - Clinical Social Worker 1052736154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Charities Neighborhood Services IncGroup PAC ID 4880506260, 11 clinicians

Practice addresses (Care Compare)

1623 Flatbush Ave
Brooklyn, NY 11210-3262
Phone (718) 951-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
094430-1NYMDSocial Worker
089377NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Neighborhood Services, Inc. CurrentSince Apr 3, 2020 Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients
Catholic Charities Neigborhood Services PastSince Nov 10, 2019 Accepting new patients

Locations

1623 Flatbush Ave
Brooklyn, NY 11210
Phone (718) 377-5755

191 Joralemon St
Fl 11
Brooklyn, NY 11201

6729 Myrtle Ave
Glendale, NY 11385
Phone (718) 456-7001

16110 Jamaica Ave
Fl 2
Jamaica, NY 11432
Phone (718) 674-1000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1346659398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161-10 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161-10 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-704-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLADINO",
        "first_name": "JACQUELINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094430-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.