Fajr Salaam-Goodwin, MSW, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL06379700 Issued in NJ

Practice address

640 Eagle Rock Ave Ste 1
West Orange, NJ 07052-2931

Phone

(908) 803-9550

NPI assigned

Jun 27, 2024

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peace Journey

  • Community/Behavioral Health Agency
  • Bloomfield, NJ
  • NPI 1801602537
  NPD Authorized official

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1295570513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PATTON DR APT A",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035283",
            "telephone_number": "908-803-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 EAGLE ROCK AVE STE 1",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522931",
            "telephone_number": "908-803-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAAM-GOODWIN",
        "first_name": "FAJR",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06379700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saint Barnabas Outpatient Centers
• Saint Barnabas Outpatient Centers
• Saint Barnabas Palliative Care Physicians PA
• Jocelyne Saint-Natus
• Jacqueline Danielle Saitta, M.D.
• Salas Plastic Surgery
• A Peter Salas, MD, FACS, FACM
• Michael Salierno, MD
• Sally Attia, LLC
• Samantha Jean Salomon, MD

• All providers in West Orange, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.