Active NPI
Paul F Jaquith, LCSW
- Clinical Social Worker
- Miami Gardens, FL
National Provider Identifier
1366746158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 6339
- Practice address
- 111 NW 183Rd St
Miami Gardens, FL 33169-4537 - Phone
- (954) 414-8723
- NPI assigned
- Jan 7, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 6339 | FL | Primary |
Addresses
Primary practice location
111 NW 183Rd St
Miami Gardens, FL 33169-4537
Mailing address
111 NW 183Rd St
Miami Gardens, FL 33169-4537
Phone (954) 414-8723
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW 6339 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayview Center for Mental Health Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- North Miami Beach, FL
- NPI 1912123456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294358400000",
"number": "1366746158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NW 183RD ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "331694537",
"telephone_number": "954-414-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 NW 183RD ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "331694537",
"telephone_number": "954-414-8723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAQUITH",
"first_name": "PAUL",
"middle_name": "F",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-07",
"last_updated": "2011-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 6339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.