Jacqueline Grecko, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW19424 Issued in FL

Practice address

16091 Blatt Blvd Apt 301
Weston, FL 33326-1440

Phone

(216) 789-9702

NPI assigned

Mar 14, 2023

Last updated

Mar 14, 2023By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1700587946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16091 BLATT BLVD APT 301",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16091 BLATT BLVD APT 301",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261440",
            "telephone_number": "216-789-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECKO",
        "first_name": "JACQUELINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700410",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Icylin Graham-Samuels, RN
• Amanda Raveli Grant, APRN-BC
• Avalon Karen Grantham, APRN, FNP-BC
• Bertram Grapin
• Greater Florida Anesthesiologists, LLC
• Beverly Cypen Greenberg, D.O.
• Ryan Merrill Greene, MD, PHD
• Aleyah Monique Greer
• Janolyn S Gregg, PHD
• Brian Grenda, PT

• Clinical Social Worker in Weston, FL
• Providers in Weston, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.