Living Well 4 Life

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LIVING WELL 4 LIFE

Practice address

405 Daffodil Dr
Jackson, NJ 08527-4125

Phone

(732) 966-5809

NPI assigned

Jul 6, 2020

Organization subpart

No

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

Authorized official

Name

Rekishia L McMillan, MSW

Title

Owner

Phone

(732) 966-5809

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1174140271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 DAFFODIL DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274125",
            "telephone_number": "732-966-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 DAFFODIL DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274125",
            "telephone_number": "732-966-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL 4 LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "REKISHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-966-5809",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14356384",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naftoli David Levin, P.A
• Eliana Levy
• Elizabeth Lewis, RN, BSN
• Asher Lipner, PHD
• Sherry Liu
• Lydia Berger Locke, MA,CCC-SLP
• Tracy Allyn Lockwood, LCSW
• Imirrah B Logan
• Alysa Rae Longo
• Serena Lyn Lopez, COTA/L

• Clinical Social Worker in Jackson, NJ
• Providers in Jackson, 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 6, 2020; 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.