Individual provider Active NPI

Mary Ann Forster, L.C.S.W.

  • Mental Health Counselor
  • Montclair, NJ
National Provider Identifier
1013078658
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC04336500 Issued in NJ
Practice address
101 Park St
Montclair, NJ 07042-2963
Phone
(201) 503-4943
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SC04336500 NJ Primary

Addresses

Primary practice location

101 Park St
Montclair, NJ 07042-2963

Mailing address

111 Arnot PL
Wood Ridge, NJ 07075-1426
Phone (201) 503-4943

Other names 1

  • Ms. Mary Ann Forster-King Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311000993 NJ Practitioner - Clinical Social Worker 3779472485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Park St
Suite 1
Montclair, NJ 07042-2963
Phone (201) 503-4943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1013078658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ARNOT PL",
            "city": "WOOD RIDGE",
            "state": "NJ",
            "postal_code": "070751426",
            "telephone_number": "201-503-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422963",
            "telephone_number": "201-503-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSTER",
        "first_name": "MARY ANN",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC04336500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "FORSTER-KING",
            "prefix": "MS.",
            "credential": "L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.