Individual provider Active NPI

Andree F. Mindnich

  • Clinical Social Worker
  • Watchung, NJ
National Provider Identifier
1114515905
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC0039350 Issued in NJ
Practice address
786 Mountain Blvd Ste 104
Watchung, NJ 07069-6268
Phone
(908) 322-9623
Fax
(908) 322-8703
NPI assigned
Jan 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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 44SC0039350 NJ Primary

Addresses

Primary practice location

786 Mountain Blvd Ste 104
Watchung, NJ 07069-6268

Mailing address

786 Mountain Blvd Ste 104
Watchung, NJ 07069-6268
Phone (908) 322-9623

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
I20210204000039 NJ Practitioner - Clinical Social Worker 0042624975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Calm and Sense - WatchungGroup PAC ID 8628389558, 7 clinicians

Practice addresses (Care Compare)

31 Mountain Blvd
BLDG U
Warren, NJ 07059-5648
Phone (908) 322-9623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC0039350NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Calm and Sense - Watchung CurrentSince Feb 20, 2021 Accepting new patients

Locations

31 Mountain Blvd
Bldg U
Warren, NJ 07059
Phone (908) 322-9623

786 Mountain Blvd
Ste 104
Watchung, NJ 07069
Phone (908) 322-9623

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": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1114515905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 MOUNTAIN BLVD STE 104",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696268",
            "telephone_number": "908-322-9623",
            "fax_number": "908-322-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 MOUNTAIN BLVD STE 104",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696268",
            "telephone_number": "908-322-9623",
            "fax_number": "908-322-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDNICH",
        "first_name": "ANDREE",
        "middle_name": "F.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC0039350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watchung, NJ

Sources for this page

Verify at the official NPI Registry.