Patricia Shine, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05488100 Issued in NJ

Practice address

250 Old Hook Rd
Westwood, NJ 07675-3123

Phone

(201) 781-1326

Fax

(201) 383-1982

NPI assigned

Jul 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Thomas R Martin Mental Health Counselor PLLC

  • Mental Health Counselor
  • Nanuet, NY
  • NPI 1568006203
  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1306253752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753123",
            "telephone_number": "201-781-1326",
            "fax_number": "201-383-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753123",
            "telephone_number": "201-781-1326",
            "fax_number": "201-383-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05488100",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077925-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pritesh J Shah, M.D.
• Shivani Shah, MD
• Thomas R Shannon, DDS
• Jessica Shea, LCSW
• Jason Sheehan, DPT
• Irene Shuman, DDS
• Silver Light Counseling LLC
• Benjamin Silverman, LPC
• Malwinder Singh, MD
• Sudir K Sinha, M.D.

• Clinical Social Worker in Westwood, NJ
• Providers in Westwood, 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 Jul 17, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.