Individual provider Active NPI

Angel Luis Morales, LMSW/LSW

  • Clinical Social Worker
  • North Bergen, NJ
National Provider Identifier
1063173706
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113504-01 Issued in NY
Practice address
321 79TH St
North Bergen, NJ 07047
Phone
(917) 364-0303
NPI assigned
Jan 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 44SL06749200 NJ
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 113504-01 NY Primary

Addresses

Primary practice location

321 79TH St
North Bergen, NJ 07047

Mailing address

18 Tammy Drive
Middletown, NY 10941-2052
Phone (646) 319-5427

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

LicenseStateTypeSpecialty
44SL06749200NJMDClinical Social Worker
113504-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Counseling Services Multi-Specialty CurrentSince Jan 17, 2022 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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1063173706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TAMMY DRIVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109412052",
            "telephone_number": "646-319-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 79TH ST",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "07047",
            "telephone_number": "917-364-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "ANGEL",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "LMSW/LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06749200",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "113504-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.