Jacqueline Kim Szabo, LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05384000 Issued in NJ

Legal business name

JACQUELINE KIM SZABO, LCSW LLC

Practice address

2185 Lemoine Ave
Suite 1E
Fort Lee, NJ 07024-6036

Phone

(201) 983-9275

Fax

(201) 548-5047

NPI assigned

Dec 3, 2015

Last updated

Dec 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jacqueline Szabo, LCSWNPI 1346480704

Title

Owner

Phone

(201) 983-9275

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Szabo, LCSW

  • Clinical Social Worker
  • Ridgewood, NJ
  • NPI 1346480704
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1093180911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "SUITE 1E",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246036",
            "telephone_number": "201-983-9275",
            "fax_number": "201-548-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "SUITE 1E",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246036",
            "telephone_number": "201-983-9275",
            "fax_number": "201-548-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE KIM SZABO, LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "SZABO",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-983-9275",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05384000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fort Lee, NJ
• Providers in Fort Lee, 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 Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.