Ingrid Jackelin Nolasco

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06102400 Issued in NJ

Practice address

648 Clark Ave
Ridgefield, NJ 07657-2719

Phone

(201) 895-3110

NPI assigned

Apr 13, 2023

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

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": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1194411033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 63RD ST APT 7",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070933036",
            "telephone_number": "201-895-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 CLARK AVE",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076572719",
            "telephone_number": "201-895-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLASCO",
        "first_name": "INGRID",
        "middle_name": "JACKELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06102400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ridgefield, NJ
• Providers in Ridgefield, 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 Apr 13, 2023; 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.