Active NPI
David Rodriguez, LCSW
- Clinical Social Worker
- Englewood, NJ
National Provider Identifier
1194242453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC05826000
- Practice address
- 93 W Palisade Ave
Englewood, NJ 07631-2611 - Phone
- (201) 567-0500
- NPI assigned
- Aug 28, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05826000 | NJ | Primary |
Addresses
Primary practice location
93 W Palisade Ave
Englewood, NJ 07631-2611
Mailing address
8325 Kennedy Blvd
Apt 3B
North Bergen, NJ 07047-4258
Phone (201) 421-0515
Other practice location 1
6 Cornwall Ct Ste B
East Brunswick, NJ 08816-3347
Phone (732) 955-4141
Other practice location 2
1945 Morris Ave
Union, NJ 07083-3526
Phone (908) 291-2727
Other practice location 3
2 Park Ave
Dumont, NJ 07628-3004
Phone (201) 567-0059
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05826000 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1194242453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8325 KENNEDY BLVD",
"address_2": "APT 3B",
"city": "NORTH BERGEN",
"state": "NJ",
"postal_code": "070474258",
"telephone_number": "201-421-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 W PALISADE AVE",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076312611",
"telephone_number": "201-567-0500"
}
],
"practiceLocations": [
{
"address_1": "6 Cornwall Ct Ste B",
"address_purpose": "LOCATION",
"city": "East Brunswick",
"state": "NJ",
"postal_code": "088163347",
"country_code": "US",
"telephone_number": "732-955-4141",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1945 Morris Ave",
"address_purpose": "LOCATION",
"city": "Union",
"state": "NJ",
"postal_code": "070833526",
"country_code": "US",
"telephone_number": "908-291-2727",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Park Ave",
"address_purpose": "LOCATION",
"city": "Dumont",
"state": "NJ",
"postal_code": "076283004",
"country_code": "US",
"telephone_number": "201-567-0059",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-28",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05826000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.