Individual provider Active NPI

Abby Underwood Maitland, MSW, LCSW

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1114286564
Registry record updated Sep 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05745800 Issued in NJ
Practice address
374 Hickory St
Teaneck, NJ 07666-4031
Phone
(740) 501-7362
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 085428 NY
Clinical Social Worker 1041C0700X 0700935 OH
Clinical Social Worker 1041C0700X 44SC05745800 NJ Primary

Addresses

Primary practice location

374 Hickory St
Teaneck, NJ 07666-4031

Mailing address

374 Hickory St
Teaneck, NJ 07666-4031
Phone (740) 501-7362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085428NYMDClinical Social Worker
0700935OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1114286564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 HICKORY ST",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664031",
            "telephone_number": "740-501-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 HICKORY ST",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664031",
            "telephone_number": "740-501-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITLAND",
        "first_name": "ABBY",
        "middle_name": "UNDERWOOD",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085428",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0700935",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05745800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.