Individual provider Active NPI

Cecilia Eloisa Peraza, LCSW

  • Clinical Social Worker
  • Hoboken, NJ
National Provider Identifier
1164021630
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06047000 Issued in NJ
Practice address
221 River St Ste 9
Hoboken, NJ 07030-5990
Phone
(516) 430-7306
NPI assigned
Oct 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL06410900 NJ
Clinical Social Worker 1041C0700X 44SC06047000 NJ Primary

Addresses

Primary practice location

221 River St Ste 9
Hoboken, NJ 07030-5990

Mailing address

221 River St Ste 9
Hoboken, NJ 07030-5990
Phone (516) 430-7306

Other identifiers 2

IdentifierTypeStateIssuer
44SC06047000OtherNJNEW JERSEY BOARD OF SOCIAL WORK EXAMINERS
44SL06410900OtherNJNEW JERSEY BOARD OF SOCIAL WORK EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

30 Knightsbridge Rd
Suite 625
Piscataway, NJ 08854-3948

30 Knightsbridge Rd
Suite 625
Piscataway, NJ 08854-3962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06410900NJMDSocial Worker
44SC06047000NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1164021630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 RIVER ST STE 9",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305990",
            "telephone_number": "516-430-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RIVER ST STE 9",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305990",
            "telephone_number": "516-430-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERAZA",
        "first_name": "CECILIA",
        "middle_name": "ELOISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-25",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06410900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06047000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "44SC06047000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "44SL06410900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.