Raenelle Bacchus, LCSW, LCADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05688600 Issued in NJ

Practice address

185 Claremont Ave
Jersey City, NJ 07305-3623

Phone

(201) 903-5482

NPI assigned

Jul 3, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Your Possabilities LLC

  • Social Worker
  • Jersey City, NJ
  • NPI 1053766709
  NPD (past) Authorized official

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1134615933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 CLAREMONT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073053623",
            "telephone_number": "201-903-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 CLAREMONT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073053623",
            "telephone_number": "201-903-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "RAENELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00254800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05688600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azz Medical Associates PC
• B&T Medical Transport LLC
• Aneeqa Babar, DO
• Farrukh Babar
• Jonathan Babia, RN
• Jiyoung Back, FNP
• Lauren Bacotti, BCBA
• Tanzeela Badar
• Badawy Mohamed Badawy, M.D.
• Mary Badawy, PHARM.D.

• Clinical Social Worker in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.