Individual provider Active NPI

Mary Lou Daley, LCSW

  • Clinical Social Worker
  • Chatham, NJ
National Provider Identifier
1205987476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
12 Orchard Rd
Chatham, NJ 07928-2325
Phone
(973) 701-7979
Fax
(973) 635-3119
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NJ Primary

Addresses

Primary practice location

12 Orchard Rd
Chatham, NJ 07928-2325

Mailing address

12 Orchard Rd
Chatham, NJ 07928-2325
Phone (973) 701-7979

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
I20100309000761 NJ Practitioner - Clinical Social Worker 8527103951 Practice locations: Chatham, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University Medical College - NLG, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Orchard Rd
Chatham, NJ 07928-2325
Phone (973) 701-7979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SCO4559100NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205987476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ORCHARD RD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282325",
            "telephone_number": "973-701-7979",
            "fax_number": "973-635-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ORCHARD RD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282325",
            "telephone_number": "973-701-7979",
            "fax_number": "973-635-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "MARY LOU",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

Verify at the official NPI Registry.