Individual provider Active NPI

Kerrin Tierney, LCSW

  • Clinical Social Worker
  • New Brunswick, NJ
National Provider Identifier
1306269279
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05203000 Issued in NJ
Practice address
254 Easton Ave
Care Coordination Dept.
New Brunswick, NJ 08901-1766
Phone
(732) 745-8560
Fax
(732) 745-1902
NPI assigned
Jan 29, 2014
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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 44SC05203000 NJ Primary

Addresses

Primary practice location

254 Easton Ave
Care Coordination Dept.
New Brunswick, NJ 08901-1766

Mailing address

254 Easton Ave
Care Coordination Dept.
New Brunswick, NJ 08901-1766
Phone (732) 745-8560

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
44SC05203000NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1306269279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "address_2": "CARE COORDINATION DEPT.",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "address_2": "CARE COORDINATION DEPT.",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8560",
            "fax_number": "732-745-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "KERRIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05203000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.