Individual provider Active NPI

Corinne Reilly, LCSW

  • Social Worker
  • Galloway, NJ
National Provider Identifier
1033646336
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SC06284500 Issued in NJ
Practice address
310 Chris Gaupp Dr Ste 105
Galloway, NJ 08205-4461
Phone
(609) 652-4040
NPI assigned
May 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SC06284500 NJ Primary

Addresses

Primary practice location

310 Chris Gaupp Dr Ste 105
Galloway, NJ 08205-4461

Mailing address

5 Pelican Ave
Barnegat, NJ 08005

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
I20231210000032 NJ Practitioner - Clinical Social Worker 9335598861 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifebulb LLCGroup PAC ID 2062881162, 97 clinicians

Practice addresses (Care Compare)

310 Chris Gaupp Dr
Suite 105
Galloway, NJ 08205-4461
Phone 60965240401105

505 Main St
Toms River, NJ 08753-7443
Phone (732) 272-0127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06284500NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC CurrentSince Nov 1, 2023 Accepting new patients
Life Empowerment Counseling Center LLC. CurrentSince Dec 9, 2024 Accepting new patients
Thrive Counseling LLC CurrentSince Jun 3, 2024 Accepting new patients
Lifebulb LLC CurrentSince Jun 3, 2024 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

3 Lincoln Hwy
Ste 102A
Edison, NJ 08820

310 Chris Gaupp Dr
Ste 105
Galloway, NJ 08205
Phone (609) 652-4040

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

Organizations & group practices 4

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": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1033646336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PELICAN AVE",
            "city": "BARNEGAT",
            "state": "NJ",
            "postal_code": "08005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CHRIS GAUPP DR STE 105",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054461",
            "telephone_number": "609-652-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "CORINNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC06284500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.