Individual provider Active NPI

Patricia Comly, LCSW

  • Clinical Social Worker
  • Fair Lawn, NJ
National Provider Identifier
1063846376
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00883300 Issued in NJ
Practice address
12-19 River Rd
Fair Lawn, NJ 07410-1843
Phone
(201) 703-4371
Fax
(201) 703-4376
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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 44SC00883300 NJ Primary

Addresses

Primary practice location

12-19 River Rd
Fair Lawn, NJ 07410-1843

Mailing address

12-19 River Rd
Fair Lawn, NJ 07410-1843
Phone (201) 703-4371

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
44SC00883300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bethany Christian Services 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": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1063846376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-19 RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101843",
            "telephone_number": "201-703-4371",
            "fax_number": "201-703-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-19 RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101843",
            "telephone_number": "201-703-4371",
            "fax_number": "201-703-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMLY",
        "first_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00883300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.