Individual provider Active NPI

Robert Friedman

  • Clinical Social Worker
  • Montclair, NJ
National Provider Identifier
1104178235
Registry record updated Oct 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05438100 Issued in NJ
Practice address
30 Orange Rd
Montclair, NJ 07042-2110
Phone
(973) 744-6524
NPI assigned
Oct 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2012

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 44SC05438100 NJ Primary

Addresses

Primary practice location

30 Orange Rd
Montclair, NJ 07042-2110

Mailing address

74 Pleasant Ave
Montclair, NJ 07042-3114
Phone (973) 641-1553

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
I20121130000099 NJ Practitioner - Clinical Social Worker 1658523469 Reassigns benefits to 1 organization
Practice locations: Montclair, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 Orange Rd
Montclair, NJ 07042-2110
Phone (973) 641-1553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care Psychology of NJ PC CurrentSince Jun 11, 2018 Accepting new patients

Locations

101 N Grove St
East Orange, NJ 07017
Phone (973) 672-1700

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

560 Berkeley Ave
Orange, NJ 07050
Phone (973) 672-6500

123 W 7th St
Plainfield, NJ 07060
Phone (908) 754-2211

Organizations & group practices 1

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": "1350086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350086400000",
    "number": "1104178235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 PLEASANT AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423114",
            "telephone_number": "973-641-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ORANGE RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422110",
            "telephone_number": "973-744-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-13",
        "last_updated": "2012-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05438100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.