Jeremy Medina

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096856 Issued in NY

Practice address

151 Lawrence St FL 4
Brooklyn, NY 11201-5240

Phone

(917) 685-2396

NPI assigned

Oct 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Center for Alternative Sentencing and Employment Services

  • Adult Mental Health Clinic/Center
  • New York, NY
  • NPI 1922165117
  NPD (past)

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1376143784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 LAWRENCE ST FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 LAWRENCE ST FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015240",
            "telephone_number": "917-685-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanoa Medina, MD
• Dana Tyler Medina
• Destiny Medina
• Elizabeth Medina, MSW
• Gladys Medina
• Jillian Aubrey Medina
• Jose Medina, PA
• Kadisha L Medina, CASAC-T
• Kiara Medina
• Marina Medina

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, 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 24, 2025; 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.