Jacob Studioso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

090619 Issued in NY

Practice address

84 Avon Geneseo Rd Ste B
Geneseo, NY 14454

Phone

(585) 628-4200

NPI assigned

Sep 26, 2017

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 8, 2024 through Feb 8, 2028

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jacob Studioso, LCSW, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Geneseo, NY
  • NPI 1790421329
  NPD Authorized official
• Nicholas H. Noyes Memorial Hospital

  • General Acute Care Hospital
  • Dansville, NY
  • NPI 1982625661
  NPD (past)

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1457860025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 706",
            "city": "GENESEO",
            "state": "NY",
            "postal_code": "144540706",
            "telephone_number": "585-628-4200",
            "fax_number": "585-628-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 AVON GENESEO RD STE B",
            "city": "GENESEO",
            "state": "NY",
            "postal_code": "14454",
            "telephone_number": "585-628-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDIOSO",
        "first_name": "JACOB",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-03-10",
        "certification_date": "2022-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101152",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Marie Stewart, OT/L
• Emily Rose Stone, NP
• Tera Lee Storms, PSY.D.
• Strong Optical Shop
• Linda Struble, CSW-R
• Amy Lynn Sullivan
• Rachel A Sullivan, M.S. ED. CF-SLP
• Sun Valley Medical Services, P.C.
• Susan S Debruyne D/B/a Southside Hearing Center
• Jordanne Donielle Swanson, NP

• Clinical Social Worker in Geneseo, NY
• Providers in Geneseo, 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 Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.