Kenneth Ira Mandel

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC01163800 Issued in NJ

Practice address

12 Monmouth Rd
Elizabeth, NJ 07208

Phone

(908) 527-6361

NPI assigned

Jun 26, 2023

Sex

Male

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098
  NPD

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1285310250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MONMOUTH RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07208",
            "telephone_number": "908-527-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MONMOUTH RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07208",
            "telephone_number": "908-527-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEL",
        "first_name": "KENNETH",
        "middle_name": "IRA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01163800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orrin Paul Main
• Tony Malek, NP-C
• Ashley Mancini, PA-C
• Karen Ann Mancini, D.M.D.
• Fagie Mandel Greenberg, BCBA
• Olfea D. Mangle, PT
• Jessica E Mangot, PA-C
• Ruby Mangsatabam, M.D.
• Manish Patel MD PC
• Ashraf H Mansour, M.D.

• Clinical Social Worker in Elizabeth, NJ
• Providers in Elizabeth, 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 Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.