Jaclyn Domenica Dimarco, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096024 Issued in NY

Practice address

7925 Winchester Blvd
Queens Village, NY 11427-2128

Phone

(718) 264-4478

NPI assigned

May 29, 2019

Last updated

Oct 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1457919177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-264-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-264-4478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 S Oyster Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "NY",
            "postal_code": "118013510",
            "country_code": "US",
            "telephone_number": "516-822-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMARCO",
        "first_name": "JACLYN",
        "middle_name": "DOMENICA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "108513",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096024",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ardalis Diaz
• Barbara Dieudonne, LPN
• Nichelle Nicole Diggs, R.N.
• Kawana Ruby Dillard, RN
• Sandy Dimanche, RDMS
• Shahzaria Din, BS
• Divine Mercy Tender Loving Care (Dmtlc) LLC
• Marjette Dixon-Rosip
• Guerda Dodard
• Salaam Doggett, LPN

• Clinical Social Worker in Queens Village, NY
• Providers in Queens Village, 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 Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.