Mindy Robin Patrisso

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04945100 Issued in NJ

Practice address

12 Smull Ave
Caldwell, NJ 07006-5012

Phone

(973) 494-4068

NPI assigned

Jul 29, 2019

Last updated

Jul 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1194379156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 ANNIN RD",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066811",
            "telephone_number": "973-494-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SMULL AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065012",
            "telephone_number": "973-494-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRISSO",
        "first_name": "MINDY",
        "middle_name": "ROBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04945100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE CLIENTS",
            "identifier": "060300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristina Orozco
• Natalie Pagan
• Anthony Papa
• Sonal Patel, BS. OTR/L
• Urvish A Patel, RPH
• Douglas B Paul, OPTICIAN
• Linda Perry, PMHNP-BC, CNM
• Melissa Petrone, LCSW
• Dimitry Polishchuk
• Salvatrice Rosalia Polizzotto, MSW, LCSW LLC

• Clinical Social Worker in Caldwell, NJ
• Providers in Caldwell, 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 29, 2019; 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.