Individual provider Active NPI

Winfred Odriscoll, LSW

  • Clinical Social Worker
  • Paramus, NJ
National Provider Identifier
1023360815
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05560100 Issued in NJ
Practice address
37 W Century Rd
111
Paramus, NJ 07652-1409
Phone
(201) 262-2244
Fax
(201) 262-2246
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05560100 NJ Primary

Addresses

Primary practice location

37 W Century Rd
111
Paramus, NJ 07652-1409

Mailing address

725 River Rd Ste 102a
Edgewater, NJ 07020-1172
Phone (239) 410-0988

Other identifiers 1

IdentifierTypeStateIssuer
1023360815MedicaidNJ

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
I20140709000804 NJ Practitioner - Clinical Social Worker 1153546023 Practice locations: Edgewater, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

725 River Rd
102A
Edgewater, NJ 07020-1172
Phone (239) 410-0988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1023360815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 102A",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201172",
            "telephone_number": "239-410-0988",
            "fax_number": "201-758-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W CENTURY RD",
            "address_2": "111",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521409",
            "telephone_number": "201-262-2244",
            "fax_number": "201-262-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODRISCOLL",
        "first_name": "WINFRED",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05560100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023360815",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.