Individual provider Active NPI

Carrie Fine, L.C.S.W

  • Clinical Social Worker
  • Freehold, NJ
National Provider Identifier
1083033633
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05474300 Issued in NJ
Practice address
22 Court St
Freehold, NJ 07728-1700
Phone
(732) 780-7387
Fax
(732) 780-5157
NPI assigned
Apr 10, 2014
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 44SC05474300 NJ Primary

Addresses

Primary practice location

22 Court St
Freehold, NJ 07728-1700

Mailing address

17 Cloverleaf Dr
Marlboro, NJ 07746-1882
Phone (732) 688-7890

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
I20150728003898 NJ Practitioner - Clinical Social Worker 1254645823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CPC Behavioral Healthcare IncGroup PAC ID 3971593161, 58 clinicians

Practice addresses (Care Compare)

22 Court St
Freehold, NJ 07728-1700
Phone (732) 780-7387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05474300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CPC Integrated Health, Inc. Current Accepting new patients
CPC Behavioral Healthcare, Inc CurrentSince Jun 14, 2015 Accepting new patients
CPC Integrated Health, Inc. Past Accepting new patients

Locations

10 Industrial Way E
Eatontown, NJ 07724
Phone (732) 935-2220

22 Court St
Freehold, NJ 07728
Phone (732) 780-7387

37 Court St
Freehold, NJ 07728
Phone (732) 780-7387

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1083033633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CLOVERLEAF DR",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461882",
            "telephone_number": "732-688-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 COURT ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281700",
            "telephone_number": "732-780-7387",
            "fax_number": "732-780-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "CARRIE",
        "credential": "L.C.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05474300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.