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NPI Code Detail

MEDICARE: MS. JACQUELINE ROCIO VALENCIA LCSW

MEDICARE: MS. JACQUELINE ROCIO VALENCIA LCSW
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
1104100000XSocial Worker069569NY
21041C0700XClinical Social Worker076082NY

General Provider Information

NPI Number : 1770523649
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELINE ROCIO VALENCIA LCSW
Provider Business Mailing Address
First Line : 160-53 24TH AVE
Second Line : WHITESTONE
City : QUEENS
State : NY
Zip : 11357
Country : US
Telephone Number : 718-339-9045
Fax Number :
Provider Business Practice Location Address
First Line : 333 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5947
Country : US
Telephone Number : 718-339-9080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 11/04/2009

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