Active NPI
Keira Hauck
- Clinical Social Worker
- Montclair, NJ
National Provider Identifier
1033405980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC05287500
- Practice address
- 33 S Fullerton Ave
Montclair, NJ 07042-3358 - Phone
- (973) 509-9777
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05287500 | NJ | Primary |
Addresses
Primary practice location
33 S Fullerton Ave
Montclair, NJ 07042-3358
Mailing address
33 S Fullerton Ave
Montclair, NJ 07042-3358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05287500 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Positive Development Medical of New Jersey PC | Clinical | Past | Accepting new patients |
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": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1033405980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 S FULLERTON AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 S FULLERTON AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423358",
"telephone_number": "973-509-9777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUCK",
"first_name": "KEIRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05287500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.