John Petrocco III, M.S.W., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05414600 Issued in NJ

Practice address

1753 Forge Pond Rd
Brick, NJ 08724-2936

Phone

(732) 890-8007

NPI assigned

Jul 26, 2016

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1164975249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 FORGE POND RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242936",
            "telephone_number": "732-890-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 FORGE POND RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242936",
            "telephone_number": "732-890-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCCO",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05414600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Victor Perle, DMD
• Wilfred Jagoriles Perono, P.T.
• Sabrina Jeanette Peros
• Peter E. Lowenstein DC PA
• Gretchen Lynn Peters, MSN, APRN, FNP-C
• Oleksandra Petryna, MD
• Rebecca Leigh Pfeffer, PHARMD, BCACP
• Jesse Phalanukorn
• Physician Management Services of New Jersey II, LLC
• Physicians Dialysis Brick LLC

• 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 Jul 26, 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.