Individual provider Active NPI

Michele H Pitzer, MSW

  • Clinical Social Worker
  • Chatham, NJ
National Provider Identifier
1346571668
Registry record updated Jun 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05185500 Issued in NJ
Practice address
10 Fairmount Ave
Breaking the Chain Counseling, LLC
Chatham, NJ 07928-2343
Phone
(732) 450-0533
Fax
(732) 787-5717
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2012

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 44SC05185500 NJ Primary

Addresses

Primary practice location

10 Fairmount Ave
Breaking the Chain Counseling, LLC
Chatham, NJ 07928-2343

Mailing address

651 Monmouth Ave
Breaking the Chain Counseling, LLC
Port Monmouth, NJ 07758-1517
Phone (732) 450-0533

Other identifiers 1

IdentifierTypeStateIssuer
179291OtherNJMEDICARE PTAN

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
I20040902000068 NJ Practitioner - Clinical Social Worker 1951376821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breaking the Chain Counseling, LLCGroup PAC ID 8820127988, 2 clinicians

Practice addresses (Care Compare)

248 Main St
FL 2
Chatham, NJ 07928-2412
Phone (732) 298-0301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
44SC05185500NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evers Psychological Associates PC PastSince Mar 6, 2011 Accepting new patients

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": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338681600000",
    "number": "1346571668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 MONMOUTH AVE",
            "address_2": "BREAKING THE CHAIN COUNSELING, LLC",
            "city": "PORT MONMOUTH",
            "state": "NJ",
            "postal_code": "077581517",
            "telephone_number": "732-450-0533",
            "fax_number": "732-787-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FAIRMOUNT AVE",
            "address_2": "BREAKING THE CHAIN COUNSELING, LLC",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282343",
            "telephone_number": "732-450-0533",
            "fax_number": "732-787-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITZER",
        "first_name": "MICHELE",
        "middle_name": "H",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2012-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05185500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "179291",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

Verify at the official NPI Registry.