Individual provider Active NPI

Nicole Marie Kemprowski, LCSW

  • Clinical Social Worker
  • Matawan, NJ
National Provider Identifier
1205657889
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06377000 Issued in NJ
Practice address
100 Belchase Dr Ste 101
Matawan, NJ 07747-9761
Phone
(732) 707-4100
Fax
(732) 707-4101
NPI assigned
Oct 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00355900 NJ
Clinical Social Worker 1041C0700X 44SC06377000 NJ Primary

Addresses

Primary practice location

100 Belchase Dr Ste 101
Matawan, NJ 07747-9761

Mailing address

100 Belchase Dr Ste 101
Matawan, NJ 07747-9761
Phone (732) 707-4100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241031001072 NJ Practitioner - Clinical Social Worker 3870026693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jersey Medical Care,PCGroup PAC ID 0941274716, 12 clinicians

Practice addresses (Care Compare)

100 Belchase Dr
Suite 101
Matawan, NJ 07747-9728
Phone (732) 707-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06377000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey Medical Care,PC CurrentSince Oct 18, 2024 Accepting new patients

Locations

100 Belchase Dr
Ste 101
Matawan, NJ 07747
Phone (732) 290-1660

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1205657889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BELCHASE DR STE 101",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077479761",
            "telephone_number": "732-707-4100",
            "fax_number": "732-707-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BELCHASE DR STE 101",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077479761",
            "telephone_number": "732-707-4100",
            "fax_number": "732-707-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPROWSKI",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00355900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06377000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

Verify at the official NPI Registry.