Individual provider Active NPI

Jaime Merola, LMSW

  • Social Worker
  • East Elmhurst, NY
National Provider Identifier
1407254659
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
088898 Issued in NY
Practice address
2626 75TH Street
Lexington Center for MH Center
East Elmhurst, NY 11370
Phone
(718) 350-3158
Fax
(718) 350-3067
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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 088898 NY Primary

Addresses

Primary practice location

2626 75TH Street
Lexington Center for MH Center
East Elmhurst, NY 11370

Mailing address

6813 Owls Head CT
Brooklyn, NY 11220-5032
Phone (347) 838-0729

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
088898NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1407254659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6813 OWLS HEAD CT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205032",
            "telephone_number": "347-838-0729",
            "fax_number": "718-350-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 75TH STREET",
            "address_2": "LEXINGTON CENTER FOR MH CENTER",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "11370",
            "telephone_number": "718-350-3158",
            "fax_number": "718-350-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEROLA",
        "first_name": "JAIME",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.