Maryellen Guadagno, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05443400 Issued in NJ

Practice address

1289 Route 38 West
Suite 101
Hainesport, NJ 08036

Phone

(609) 267-1377

NPI assigned

Aug 21, 2006

Last updated

Oct 17, 2012By the provider in NPPES

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

Other identifiers 1

Other names 1

• Ms. Mary Ellen Pastor Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: maryellenguadagno@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328
  Medicare reassignment
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD
• The Lester a. Drenk Behavioral Health Center, Inc.

  • Community/Behavioral Health Agency
  • Hainesport, NJ
  • NPI 1366588451
  NPD (past)
• Puerto Rican Family Institute, Inc.

  • Community/Behavioral Health Agency
  • Elmhurst, NY
  • NPI 1023122181
  NPD (past)
• Puerto Rican Family Institute, Inc.

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1609980762
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1336254895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 ROUTE 38 WEST",
            "address_2": "SUITE 101",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "08036",
            "telephone_number": "609-261-3330",
            "fax_number": "609-265-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 ROUTE 38 WEST",
            "address_2": "SUITE 101",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "08036",
            "telephone_number": "609-267-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADAGNO",
        "first_name": "MARYELLEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072487",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05443400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS PROVIDER NUMBER",
            "identifier": "040426034419",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ELLEN",
            "last_name": "PASTOR",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis Gingrich
• Patricia Ann Goslee, ED.D.
• Great Minds ABA Therapy LLC
• Patricia Green, LCSW
• Cortney Shana Griffin, APN
• Hainesport Chiropractic LLC
• Hainesport Chiropractic PA
• Hainesport Family Medicine LLC
• Hainesport Township School District
• Melissa Hansbury, LAC

• Clinical Social Worker in Hainesport, NJ
• Providers in Hainesport, 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 Oct 17, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.