Jacqueline A McIntosh, LCSW, CASAC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

090562 Issued in NY

Practice address

159 20TH St
Brooklyn, NY 11232-1253

Phone

(646) 685-4499

Fax

(516) 218-7964

NPI assigned

Jun 2, 2016

Last updated

Nov 3, 2020By 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 2

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

• Greenhope Services for Women, Inc.

  • Substance Abuse Rehabilitation Facility
  • New York, NY
  • NPI 1073000733
  NPD (past)
• Greenhope Services for Women, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • New York, NY
  • NPI 1194942003
  NPD (past)

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1639527476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 BLACKROCK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104726103",
            "telephone_number": "914-562-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 20TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112321253",
            "telephone_number": "646-685-4499",
            "fax_number": "516-218-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "32945",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne McInnes, LCSW
• Shaakir McIntosh-Samuel, MD
• Jennifer Janet McIntosh-Wright
• Daijasia McIntosh
• Heather Ingrid McIntosh
• James Curtis McIntosh Jr., MD
• Joylene Gloria McIntosh
• Karen McIntosh
• Loretta Anne McIntosh, RN
• Michael Donald McIntosh, M.D.

• Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.