Individual provider Active NPI

Mary Lou Killian Searles, LCSW

  • Clinical Social Worker
  • Oakhurst, NJ
National Provider Identifier
1093274391
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00026500 Issued in NJ
Practice address
721 Auth Ave
Oakhurst, NJ 07755-2965
Phone
(609) 610-2596
NPI assigned
Mar 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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 44SC00026500 NJ Primary

Addresses

Primary practice location

721 Auth Ave
Oakhurst, NJ 07755-2965

Mailing address

607 New York Ave
Point Pleasant Beach, NJ 08742-3034
Phone (609) 610-2596

Other practice location 1

1301 Main St
Asbury Park, NJ 07712-5359
Phone (732) 774-6333

Other names 1

  • Mary Lou K Benoit Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL vnachc.org

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
I20211020001722 NJ Practitioner - Clinical Social Worker 5890183099 Practice locations: Oakhurst, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

721 Auth Ave
Oakhurst, NJ 07755-2965
Phone (609) 610-2596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1093274391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 NEW YORK AVE",
            "city": "POINT PLEASANT BEACH",
            "state": "NJ",
            "postal_code": "087423034",
            "telephone_number": "609-610-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 AUTH AVE",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077552965",
            "telephone_number": "609-610-2596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Main St",
            "address_purpose": "LOCATION",
            "city": "Asbury Park",
            "state": "NJ",
            "postal_code": "077125359",
            "country_code": "US",
            "telephone_number": "732-774-6333",
            "fax_number": "732-774-0313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLIAN SEARLES",
        "first_name": "MARY LOU",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-16",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00026500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "vnachc.org",
            "affiliation": "N",
            "address_1": "1301 Main St",
            "city": "Asbury Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077125359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY LOU",
            "last_name": "BENOIT",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oakhurst, NJ

Sources for this page

Verify at the official NPI Registry.