Kelly Rose Printon, LCSW, LCADC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06092600 Issued in NJ

Practice address

104 Bayard St
2ND Floor
New Brunswick, NJ 08901-2389

Phone

(732) 847-2869

Fax

(732) 851-1031

NPI assigned

Aug 24, 2016

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1326593880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 2ND AVE REAR 2ND",
            "city": "BRADLEY BEACH",
            "state": "NJ",
            "postal_code": "077201165",
            "telephone_number": "732-688-4018",
            "fax_number": "732-851-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BAYARD ST",
            "address_2": "2ND FLOOR",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012389",
            "telephone_number": "732-847-2869",
            "fax_number": "732-851-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINTON",
        "first_name": "KELLY",
        "middle_name": "ROSE",
        "name_prefix": "Miss",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00299800",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06092600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premkumar Rangala, MD PA
• Jonathan L Prenner, MD
• James Bartlett Presbrey
• Primary Care of New Brunswick PC
• Natalie Principato
• James Dmitry Prister, M.D.
• Gina Prochilo, DO
• Professional Occupational & Physical Therapy, PLLC
• Tareai Pruitt-Smith, APN
• Jana Pruski, MPH, MS, CGC

• Social Worker in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.