Active NPI
Colby Daferede, MSW, LSW
- Social Worker
- Freehold, NJ
National Provider Identifier
1154725307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05883300
- Practice address
- 501 Iron Bridge Rd
Suite 15
Freehold, NJ 07728-5304 - Phone
- (732) 866-8611
- Fax
- (732) 303-1221
- NPI assigned
- Oct 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05883300 | NJ | Primary |
Addresses
Primary practice location
501 Iron Bridge Rd
Suite 15
Freehold, NJ 07728-5304
Mailing address
501 Iron Bridge Rd
Suite 15
Freehold, NJ 07728-5304
Phone (732) 866-8611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44SL05883300 | Other | NJ | LICENSED SOCIAL WORKER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05883300 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1154725307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 IRON BRIDGE RD",
"address_2": "SUITE 15",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077285304",
"telephone_number": "732-866-8611",
"fax_number": "732-303-1221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 IRON BRIDGE RD",
"address_2": "SUITE 15",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077285304",
"telephone_number": "732-866-8611",
"fax_number": "732-303-1221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAFEREDE",
"first_name": "COLBY",
"name_prefix": "Mrs.",
"credential": "MSW, LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05883300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED SOCIAL WORKER",
"identifier": "44SL05883300",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freehold, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.