Individual provider Active NPI

Taylor Rodriguez, LCSW

  • Clinical Social Worker
  • Cherry Hill, NJ
National Provider Identifier
1124668785
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05902500 Issued in NJ
Practice address
1030 Kings Hwy N Ste 202
Cherry Hill, NJ 08034-1907
Phone
(617) 302-7962
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 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 44SC05902500 NJ Primary

Addresses

Primary practice location

1030 Kings Hwy N Ste 202
Cherry Hill, NJ 08034-1907

Mailing address

25 Ikea Dr
Westampton, NJ 08060-5115
Phone (609) 386-7331

Other names 1

  • Taylor Williams Former name

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
I20200827000261 NJ Practitioner - Clinical Social Worker 5294152880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1030 Kings Hwy N
Suite 202
Cherry Hill, NJ 08034-1907
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities, Diocese of Trenton CurrentSince May 26, 2020 Accepting new patients
Thrive Counseling LLC CurrentSince Aug 1, 2021 Accepting new patients
Lifebulb LLC PastSince Oct 16, 2022 Accepting new patients

Locations

1030 Kings Hwy N
Ste 202
Cherry Hill, NJ 08034
Phone (201) 820-0057

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

383 W State St
Trenton, NJ 08618
Phone (609) 278-4933

39 N Clinton Ave
Trenton, NJ 08609
Phone (609) 394-5157

25 Ikea Dr
Westampton, NJ 08060
Phone (609) 267-9339

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1124668785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 IKEA DR",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080605115",
            "telephone_number": "609-386-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 KINGS HWY N STE 202",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341907",
            "telephone_number": "617-302-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05902500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "WILLIAMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.