Cindy P Dornacker, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05412700 Issued in NJ

Practice address

171 Knollcrest Ave
Brick, NJ 08723-7517

Phone

(848) 448-6422

NPI assigned

Nov 3, 2008

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)

Not 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.

• Salt and Light Counseling

  • Community/Behavioral Health Agency
  • Brick, NJ
  • NPI 1821955238
  NPD Authorized official

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1164675237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 KNOLLCREST AVE",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237517",
            "telephone_number": "848-448-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 KNOLLCREST AVE",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237517",
            "telephone_number": "848-448-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNACKER",
        "first_name": "CINDY",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05291000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05412700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia Lynn Dolan, OTD, OTR/L
• Stephen Dolan, PT
• Heather Donahue, NBC-HWC
• Kathryn Donohue
• Kelly Donovan
• Kristen Dornacker, PT, DPT
• Gary Dornfeld, D.D.S
• Dawn Dougherty
• Mary Katharine Dowling, OT
• Samantha Dowstra, LAC

• Clinical Social Worker in Brick, NJ
• Providers in Brick, 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 Jan 12, 2022; 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.