Jacalyn Michele Konrad, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05170900 Issued in NJ

Practice address

106 Old Hook Road
Westood, NJ 07675

Phone

(201) 666-2400

Fax

(201) 666-2334

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in NJ

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)
• Relief & Solutions Counseling

  • Clinical Social Worker
  • Westwood, NJ
  • NPI 1265572317
  NPD (past)
• Relief & Solutions Counseling Center, LLC

  • Clinical Social Worker
  • Westwood, NJ
  • NPI 1033148762
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336162189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MAHAR AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07011",
            "telephone_number": "973-478-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 OLD HOOK ROAD",
            "city": "WESTOOD",
            "state": "NJ",
            "postal_code": "07675",
            "telephone_number": "201-666-2400",
            "fax_number": "201-666-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONRAD",
        "first_name": "JACALYN",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05170900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.