Provider Demographics
NPI:1184332595
Name:CASO, JACQUELINE NOELLE (LMSW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:NOELLE
Last Name:CASO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 DEAN ST APT F1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3101
Mailing Address - Country:US
Mailing Address - Phone:347-419-4040
Mailing Address - Fax:
Practice Address - Street 1:437 5TH AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2205
Practice Address - Country:US
Practice Address - Phone:929-552-1006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118163-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker