Jacqueline Gazzara, MSW,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW025068 Issued in PA

Practice address

1200 Atwater Dr Ste 130
Malvern, PA 19355-9912

Phone

(610) 646-1851

NPI assigned

Jan 25, 2018

Sex

Female

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

Locations

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.

• Ellie Main Line LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Malvern, PA
  • NPI 1528752037

  Clinical

  NPD

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1407354350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CITY AVE STE 15",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ATWATER DR STE 130",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193559912",
            "telephone_number": "610-646-1851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E City Ave Ste 15",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190041724",
            "country_code": "US",
            "telephone_number": "484-430-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAZZARA",
        "first_name": "JACQUELINE",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW025068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gastro Centers of Pennsylvania
• Gateway Horseworks
• Janaki Gautam
• Kelsey Gawell, CRNP
• Ellen Gayda
• Jeffrey Allen Gehret, D.O.
• Noreen Slamon Geibel, MSPT
• Brianna Lauren Gentile, LMFT
• George L. Rodriguez, M.D., PC
• Lauren McManus George, RDN

• Clinical Social Worker in Malvern, PA
• Providers in Malvern, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.