Individual provider Active NPI

Victor Llerena, LSW

  • Clinical Social Worker
  • Bayonne, NJ
National Provider Identifier
1043636632
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05668700 Issued in NJ
Practice address
17 Newark Bay CT
Bayonne, NJ 07002-1904
Phone
(201) 320-8130
NPI assigned
Mar 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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 44SC05668700 NJ Primary

Addresses

Primary practice location

17 Newark Bay CT
Bayonne, NJ 07002-1904

Mailing address

17 Newark Bay CT
Bayonne, NJ 07002-1904
Phone (201) 320-8130

Other names 1

  • Mr. Victor Llerena Other 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
I20171017002581 NJ Practitioner - Clinical Social Worker 7214203306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 Ave C
Bayonne, NJ 07002-2439
Phone (201) 320-8130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Counseling Center LLC Clinical CurrentSince Aug 6, 2017 Accepting new patients

Locations

80 Avenue C
Bayonne, NJ 07002
Phone (201) 243-6109

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": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1043636632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 NEWARK BAY CT",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070021904",
            "telephone_number": "201-320-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 NEWARK BAY CT",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070021904",
            "telephone_number": "201-320-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLERENA",
        "first_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05668700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTOR",
            "last_name": "LLERENA",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.