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NPI Code Detail

MEDICARE: ADELAIDE JACQUET LCSW-R

MEDICARE:   ADELAIDE  JACQUET  LCSW-R
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerR012050-1NY

General Provider Information

NPI Number : 1447363817
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELAIDE JACQUET LCSW-R
Provider Business Mailing Address
First Line : 355 37TH ST RM 204
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-2505
Country : US
Telephone Number : 718-965-0796
Fax Number : 718-965-1028
Provider Business Practice Location Address
First Line : 4136 27TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-3825
Country : US
Telephone Number : 718-389-5100
Fax Number : 718-391-9633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 01/18/2026

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Directions to “ ADELAIDE JACQUET LCSW-R” Practice Location

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