Individual provider Active NPI

Michael W Chabot, MSW, LCSW

  • Clinical Social Worker
  • Cherry Hill, NJ
National Provider Identifier
1124236351
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04682700 Issued in NJ
Practice address
100 Haddontowne CT
Cherry Hill, NJ 08034-3602
Phone
(856) 208-7523
Fax
(856) 427-0089
NPI assigned
May 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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 44SC04682700 NJ Primary

Addresses

Primary practice location

100 Haddontowne CT
Cherry Hill, NJ 08034-3602

Mailing address

100 Haddontowne CT
Cherry Hill, NJ 08034-3602
Phone (609) 338-3281

Other identifiers 1

IdentifierTypeStateIssuer
2548145OtherNJAETNA INSURANCE

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
I20050503000644 NJ Practitioner - Clinical Social Worker 6204875883 Reassigns benefits to 1 organization
Practice locations: Cherry Hill, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1812 Haddonfield Berlin Rd
Cherry Hill, NJ 08003-3736
Phone (609) 338-3281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04682700NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health - Behavioral Health CurrentSince Jun 1, 2022 Accepting new patients
Rutgers Health - Behavioral Health CurrentSince Jun 1, 2022 Accepting new patients
Marla B. Cohen, Psy.D., P.C. Past Accepting new patients

Locations

57 Haddonfield Rd
Ste 120
Cherry Hill, NJ 08002
Phone (856) 566-6200

671 Hoes Ln W
Rm D3381
Piscataway, NJ 08854
Phone (732) 235-3289

Organizations & group practices 3

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": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1124236351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HADDONTOWNE CT",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343602",
            "telephone_number": "609-338-3281",
            "fax_number": "856-427-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HADDONTOWNE CT",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343602",
            "telephone_number": "856-208-7523",
            "fax_number": "856-427-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABOT",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-20",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04682700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "2548145",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.