NPIMap

Organization Active NPI

Sprout Grow Blossom LLC

  • Social Worker
  • Flanders, NJ
National Provider Identifier
1336739176
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
SPROUT GROW BLOSSOM LLC
Practice address
19 Downstream Dr
Flanders, NJ 07836-9568
Phone
(973) 634-7772
NPI assigned
Jan 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Authorized official

Name
Mrs. Stephanie Fredericka, LCSWNPI 1972074813
Title
Owner/Clinician
Phone
(973) 634-7772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

19 Downstream Dr
Flanders, NJ 07836-9568

Mailing address

19 Downstream Dr
Flanders, NJ 07836-9568
Phone (973) 634-7772

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL na Other

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1336739176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DOWNSTREAM DR",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369568",
            "telephone_number": "973-634-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DOWNSTREAM DR",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369568",
            "telephone_number": "973-634-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT GROW BLOSSOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "FREDERICKA",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "973-634-7772",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "endpointDescription": "na",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "na",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "na",
            "address_1": "19 Downstream Dr",
            "city": "Flanders",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "078369568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flanders, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.