Individual provider Active NPI

John Patrick Shalhoub, LCSW

  • Clinical Social Worker
  • Bridgewater, NJ
National Provider Identifier
1093880734
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05183500 Issued in NJ
Practice address
500 N Bridge St
Bridgewater, NJ 08807-2135
Phone
(908) 725-2800
Fax
(908) 704-1790
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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 44SC05183500 NJ Primary

Addresses

Primary practice location

500 N Bridge St
Bridgewater, NJ 08807-2135

Mailing address

500 N Bridge St
Bridgewater, NJ 08807-2135
Phone (908) 725-2800

Other identifiers 2

IdentifierTypeStateIssuer
527486OtherNJAGENCY MEDICARE PROIVDER NUMBER
0023701MedicaidNJ

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
I20040719000922 NJ Practitioner - Clinical Social Worker 8426037839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northstar Counseling Services LLCGroup PAC ID 6204144165, 9 clinicians

Practice addresses (Care Compare)

114 S 2ND St
Phillipsburg, NJ 08865-1806
Phone (908) 329-2144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Counseling Services LLC Clinical CurrentSince Nov 16, 2020 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Jul 1, 2020 Accepting new patients
St. Luke'S Warren Physician Group, PC CurrentSince Jul 1, 2020 Accepting new patients
St. Luke'S Warren Physician Group, PC Current Accepting new patients

Locations

114 S 2nd St
Phillipsburg, NJ 08865
Phone (908) 329-2144

305 Roseberry St
Ste 8
Phillipsburg, NJ 08865
Phone (908) 454-7244

311 Baltimore St
Phillipsburg, NJ 08865
Phone (908) 454-8787

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1093880734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALHOUB",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05183500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICARE PROIVDER NUMBER",
            "identifier": "527486",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.