Jacqueline Durham, LLC.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JACQUELINE DURHAM, LLC.

Practice address

214 Broad St
Red Bank, NJ 07701-2026

Phone

(732) 690-2611

NPI assigned

May 20, 2019

Organization subpart

No

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

Authorized official

Name

Kathleen M. Garcia

Title

Account Manager

Phone

(856) 242-3736

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Durham, MSW, LCSW

  • Clinical Social Worker
  • Red Bank, NJ
  • NPI 1609235498
  Medicare reassignment NPD
• David Neil Lipton, PH.D.

  • Clinical Psychologist
  • Red Bank, NJ
  • NPI 1083625024
  NPD (past)

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1295392850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012026",
            "telephone_number": "732-690-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012026",
            "telephone_number": "732-690-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE DURHAM, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "856-242-3736"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Isaacson, DPT
• Iwamaye and Farber MD PA
• Jaclyn Ventre
• Alan Jacobs, P.T.
• Martin Alexander Jacobson, M.D.
• Priya Hari Jadeja, M.D.
• Thea Jandzio, LCSW
• Frank Janks
• Lina Jaramillo, LPC
• Danielle Marie Jensen, PA

• Clinical Social Worker in Red Bank, NJ
• Providers in Red Bank, 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 Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.