Individual provider Active NPI

Giovanni Huaccamayta-Jauregui

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1669960266
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093339 Issued in NY
Practice address
10470 Queens Blvd FL 2
Forest Hills, NY 11375-3638
Phone
(718) 275-6010
NPI assigned
Apr 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093339 NY Primary

Addresses

Primary practice location

10470 Queens Blvd FL 2
Forest Hills, NY 11375-3638

Mailing address

10470 Queens Blvd FL 2
Forest Hills, NY 11375-3638
Phone (718) 275-6010

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
093339NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner-Sessions Psychotherapy LCSW, PLLC Clinical Current Accepting new patients

Locations

580 5th Ave
Ste 820
New York, NY 10036
Phone (347) 470-5801

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1669960266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD FL 2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753638",
            "telephone_number": "718-275-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD FL 2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753638",
            "telephone_number": "718-275-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUACCAMAYTA-JAUREGUI",
        "first_name": "GIOVANNI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-29",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.