Individual provider Active NPI

Kathleen E. Newdeck, L.C.S.W

  • Clinical Social Worker
  • Springfield, NJ
National Provider Identifier
1124156187
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC00397400 Issued in NJ
Practice address
28 Millburn Ave
Suite 5
Springfield, NJ 07081-1039
Phone
(973) 218-1770
Fax
(973) 376-7726
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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 SC00397400 NJ Primary

Addresses

Primary practice location

28 Millburn Ave
Suite 5
Springfield, NJ 07081-1039

Mailing address

220 Presidential Dr Apt 403
Wilmington, DE 19807-3354
Phone (973) 285-0619

Other practice location 1

736 Speedwell Ave Ste 3
Morris Plains, NJ 07950-2254
Phone (973) 285-0415

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
SC00397400NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Psychiatric & Counseling Associates Past Accepting new patients

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1124156187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 PRESIDENTIAL DR APT 403",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198073354",
            "telephone_number": "973-285-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MILLBURN AVE",
            "address_2": "SUITE 5",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811039",
            "telephone_number": "973-218-1770",
            "fax_number": "973-376-7726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Speedwell Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Morris Plains",
            "state": "NJ",
            "postal_code": "079502254",
            "country_code": "US",
            "telephone_number": "973-285-0415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWDECK",
        "first_name": "KATHLEEN",
        "middle_name": "E.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC00397400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.