Active NPI
Jacqueline M Lugaro Vidal, LCSW
- Clinical Social Worker
- Miami, FL
National Provider Identifier
1891995304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW22302
- Practice address
- 9350 Sunset Dr Ste 151
Miami, FL 33173-3286 - Phone
- (786) 548-1022
- NPI assigned
- Jul 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW22302 | PR | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
9350 Sunset Dr Ste 151
Miami, FL 33173-3286
Mailing address
1505 Calle Jaguey
Urb. Los Caobos
Ponce, PR 00716-2631
Phone (787) 298-8166
Other practice location 1
1505 Calle Jaguey
urb. los caobos
Ponce, PR 00716-2631
Phone (787) 298-8166
Other practice location 2
1240 NE 39th Ave
Homestead, FL 33033-5924
Phone (786) 728-1343
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW22302 | PR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1891995304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 CALLE JAGUEY",
"address_2": "URB. LOS CAOBOS",
"city": "PONCE",
"state": "PR",
"postal_code": "007162631",
"telephone_number": "787-298-8166",
"fax_number": "787-263-4224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9350 SUNSET DR STE 151",
"city": "MIAMI",
"state": "FL",
"postal_code": "331733286",
"telephone_number": "786-548-1022"
}
],
"practiceLocations": [
{
"address_1": "1505 Calle Jaguey",
"address_2": "urb. los caobos",
"address_purpose": "LOCATION",
"city": "Ponce",
"state": "PR",
"postal_code": "007162631",
"country_code": "US",
"telephone_number": "787-298-8166",
"fax_number": "787-263-4224",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1240 NE 39th Ave",
"address_purpose": "LOCATION",
"city": "Homestead",
"state": "FL",
"postal_code": "330335924",
"country_code": "US",
"telephone_number": "786-728-1343",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUGARO VIDAL",
"first_name": "JACQUELINE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-23",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "SW22302",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.