Kyle Mack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05796300 Issued in NJ

Practice address

104 Central Park PL
Ramsey, NJ 07446-1821

Phone

(732) 615-8734

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1073092276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CENTRAL PARK PL",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461821",
            "telephone_number": "732-615-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CENTRAL PARK PL",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461821",
            "telephone_number": "732-615-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "KYLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05796300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Estrin, LCSW
• Zach Liu, MD
• James Thomas Loverde, M.D.
• Anabel Lucanie, MD
• Richard Lucanie, MD
• Mak Acupuncture Services
• Ajay Malhotra
• Eli Mallouhi, LSW
• Sari Mansheim, M.D.
• Ahmad Mansour

• Clinical Social Worker in Ramsey, NJ
• Providers in Ramsey, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.