Individual provider Active NPI

Nancy Dimitrovski, LCSW, LCADC

  • Clinical Social Worker
  • Sparta, NJ
National Provider Identifier
1245475672
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05322000 Issued in NJ
Practice address
46 Main St Ste 401
Sparta, NJ 07871-1910
Phone
(973) 945-9045
NPI assigned
Dec 15, 2008
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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 37C00144600 NJ
Clinical Social Worker 1041C0700X 44SC05322000 NJ Primary

Addresses

Primary practice location

46 Main St Ste 401
Sparta, NJ 07871-1910

Mailing address

46 Main St Ste 401
Sparta, NJ 07871-1910
Phone (973) 945-9045

Other identifiers 1

IdentifierTypeStateIssuer
1245475672OtherNJ1245475672

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL diminan2001@yahoo.com

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37C00144600NJMDAddiction (Substance Use Disorder) Counselor
44SC05322000NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1245475672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 MAIN ST STE 401",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711910",
            "telephone_number": "973-945-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 MAIN ST STE 401",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711910",
            "telephone_number": "973-945-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITROVSKI",
        "first_name": "NANCY",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37C00144600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05322000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1245475672",
            "identifier": "1245475672",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "diminan2001@yahoo.com",
            "affiliation": "N",
            "address_1": "46 Main St Ste 401",
            "city": "Sparta",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "078711910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.