Pamela J Pater-Ennis, LCSW,M.DIV., PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05339100 Issued in NJ

Practice address

114 Brookview Ter
Bergenfield, NJ 07621-3100

Phone

(201) 962-6443

Fax

(201) 541-8100

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Pamela P Ennis Other name

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

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Hudson River Care and Counseling, LLC

  • Clinical Social Worker
  • Englewood, NJ
  • NPI 1821392473
  Medicare reassignment Authorized official
• Hudson River Care and Counseling

  • Professional Counselor
  • Englewood, NJ
  • NPI 1598218919
  NPD (past) Authorized official
• Hudson River Care and Counseling, LLC.

  • Clinical Social Worker
  • Hoboken, NJ
  • NPI 1598115966
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1174656409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BROOKVIEW TERRACE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076214504",
            "telephone_number": "201-962-6443",
            "fax_number": "201-541-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BROOKVIEW TER",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076213100",
            "telephone_number": "201-962-6443",
            "fax_number": "201-541-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATER-ENNIS",
        "first_name": "PAMELA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW,M.DIV., PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R042224-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05339100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "ENNIS",
            "middle_name": "P",
            "credential": "LCSW, M.DIV, PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mabel Ore, RD
• James Earl Pagaduan, APN
• Michael S. Palance, O.D.
• Edilene F Panlilio, PHYSICAL THERAPIST
• James Park, DDS
• Pathmark Stores Inc
• Cherise Naime Paton
• Robert W Patterson, RRT
• Annmary Paul
• Camille Paunon, AGPCNP-BC

• Clinical Social Worker in Bergenfield, NJ
• Providers in Bergenfield, 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 Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.