Individual provider Active NPI

Joanne Skiba Reynolds, LCSW

  • Clinical Social Worker
  • Somerville, NJ
National Provider Identifier
1346470481
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00865900 Issued in NJ
Practice address
150 West End Avenue
Suite Ul5
Somerville, NJ 08876-3005
Phone
(201) 306-3578
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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 44SC00865900 NJ Primary

Addresses

Primary practice location

150 West End Avenue
Suite Ul5
Somerville, NJ 08876-3005

Mailing address

35 Long St
Suite Ul5
Jersey City, NJ 07305-2726
Phone (201) 306-3578

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091113000214 NJ Practitioner - Clinical Social Worker 6709924681 Practice locations: Somerville, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

150 W End Ave
Suite Ul5
Somerville, NJ 08876-1834
Phone (201) 306-3578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00865900NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1346470481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LONG ST",
            "address_2": "SUITE UL5",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052726",
            "telephone_number": "201-306-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 WEST END AVENUE",
            "address_2": "SUITE UL5",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088763005",
            "telephone_number": "201-306-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JOANNE",
        "middle_name": "SKIBA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00865900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

Verify at the official NPI Registry.