Individual provider Active NPI

Carla Marmelstein, LCSW

  • Clinical Social Worker
  • Lakewood, NJ
National Provider Identifier
1265573711
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04729400 Issued in NJ
Practice address
App1Sp LSB Preferred Behavioral Health of NJ
700 Airport Road
Lakewood, NJ 08701
Phone
(732) 367-4700
Fax
(732) 364-2253
NPI assigned
Feb 9, 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 44SC04729400 NJ Primary

Addresses

Primary practice location

App1Sp LSB Preferred Behavioral Health of NJ
700 Airport Road
Lakewood, NJ 08701

Mailing address

32 Wyoming Dr
Jackson, NJ 08527-1544
Phone (732) 363-6398

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
44SC04729400NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265573711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 WYOMING DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271544",
            "telephone_number": "732-363-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "APP1SP LSB PREFERRED BEHAVIORAL HEALTH OF NJ",
            "address_2": "700 AIRPORT ROAD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-367-4700",
            "fax_number": "732-364-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMELSTEIN",
        "first_name": "CARLA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04729400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.