Individual provider Active NPI

Beth Lara Anagnostis, LCSW

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1164651287
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04626600 Issued in NJ
Practice address
691 Cedar LN
Teaneck, NJ 07666-1702
Phone
(201) 692-0508
Fax
(201) 692-1691
NPI assigned
Jul 10, 2009
Last updated
Jul 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC04626600 NJ Primary
Clinical Social Worker 1041C0700X 6183767 NY

Addresses

Primary practice location

691 Cedar LN
Teaneck, NJ 07666-1702

Mailing address

691 Cedar LN
Teaneck, NJ 07666-1702
Phone (201) 692-0508

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
I20160518000387 NJ Practitioner - Clinical Social Worker 2466741244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Acenda, Inc.Group PAC ID 0042290678, 27 clinicians

Practice addresses (Care Compare)

42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone (844) 422-3632

42 S Delsea Dr
Glassboro, NJ 08028-2621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6183767NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acenda, Inc. Clinical CurrentSince Oct 2, 2020 Accepting new patients
Search for Self Inc Clinical Past Accepting new patients

Locations

42 Delsea Dr S
Glassboro, NJ 08028
Phone (856) 863-0006

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1164651287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661702",
            "telephone_number": "201-692-0508",
            "fax_number": "201-692-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661702",
            "telephone_number": "201-692-0508",
            "fax_number": "201-692-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAGNOSTIS",
        "first_name": "BETH",
        "middle_name": "LARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04626600",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "6183767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.