Individual provider Active NPI

Malky Shaulson, LCSW

  • Clinical Social Worker
  • Lakewood, NJ
National Provider Identifier
1346551355
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070738-1 Issued in NY
Practice address
58 Enclave Blvd
Lakewood, NJ 08701-5783
Phone
(718) 757-9290
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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 070738-1 NY Primary

Addresses

Primary practice location

58 Enclave Blvd
Lakewood, NJ 08701-5783

Mailing address

58 Enclave Blvd
Lakewood, NJ 08701-5783
Phone (718) 757-9290

Other practice location 1

1227 - 56 St
Brooklyn,, NY 11219
Phone (718) 757-9290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200623000479 NY Practitioner - Clinical Social Worker 5193957173 Practice locations: Brooklyn, NY
I20200702001610 NJ Practitioner - Clinical Social Worker 5193957173 Reassigns benefits to 1 organization
Practice locations: Lakewood, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1771 Madison Ave
Lakewood, NJ 08701-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070738-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc CurrentSince Jul 24, 2021 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jul 24, 2021 Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Interoperability endpoints

  • Direct secure messaging: malky.shaulson@chemed.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1346551355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 ENCLAVE BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015783",
            "telephone_number": "718-757-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 ENCLAVE BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015783",
            "telephone_number": "718-757-9290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1227 - 56 St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn,",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-757-9290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAULSON",
        "first_name": "MALKY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070738-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.