Individual provider Active NPI

Carol Fishelman-Rosen, LCSW

  • Clinical Social Worker
  • Pompton Lakes, NJ
National Provider Identifier
1083799217
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
NJSC01686 Issued in NJ
Practice address
409 Lincoln Ave
Pompton Lakes, NJ 07442-1304
Phone
(973) 616-8250
NPI assigned
Oct 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 NJSC01686 NJ Primary

Addresses

Primary practice location

409 Lincoln Ave
Pompton Lakes, NJ 07442-1304

Mailing address

409 Lincoln Ave
Pompton Lakes, NJ 07442-1304
Phone (973) 616-8250

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
I20050412000662 NJ Practitioner - Clinical Social Worker 2062459019 Practice locations: Monroe Township, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Monroe Township, NJ 08831
Phone (973) 632-8421

92 Drawbridge Dr
Monroe Township, NJ 08831-7926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJSC01686NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083799217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 LINCOLN AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074421304",
            "telephone_number": "973-616-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 LINCOLN AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074421304",
            "telephone_number": "973-616-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHELMAN-ROSEN",
        "first_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "NJSC01686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Lakes, NJ

Sources for this page

Verify at the official NPI Registry.