Jacqueline Concepcion, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05681200 Issued in NJ

Practice address

42 Craig St
Hazlet, NJ 07730-1625

Phone

(732) 977-9034

NPI assigned

Mar 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Premier Care LLC Dba Elder Life Home Care LLC

  • Home Health Agency
  • Tinton Falls, NJ
  • NPI 1548769326
  NPD (past)

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1144682535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ROUTE 34 STE 205",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473477",
            "telephone_number": "908-546-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 CRAIG ST",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301625",
            "telephone_number": "732-977-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "JACQUELINE",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05681200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cortney Clarke, LSW
• Maria F Clemente, MD
• Erica Colavito, PA-C
• Nancy Virginia Cole, PTA
• Comprehensive Surgical Care, LLC
• Voula Constantarakos, CCC-SLP
• Maylin Brianna Cook
• Jessica Corbin
• Beverly Cornel-Avendano, M.D.
• Reena Corvil

• Clinical Social Worker in Hazlet, NJ
• Providers in Hazlet, 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 Mar 24, 2016; 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.