Individual provider Active NPI

Catherine Dorothy Tanis, LCSW

  • Clinical Social Worker
  • Montclair, NJ
National Provider Identifier
1356779011
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05462800 Issued in NJ
Practice address
311 Claremont Ave
Montclair, NJ 07042-2240
Phone
(201) 468-1863
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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 44SC05462800 NJ Primary

Addresses

Primary practice location

311 Claremont Ave
Montclair, NJ 07042-2240

Mailing address

44 Ravine Ave
Wyckoff, NJ 07481-2919
Phone (201) 390-9107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC05462800NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1356779011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 RAVINE AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812919",
            "telephone_number": "201-390-9107",
            "fax_number": "201-612-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 CLAREMONT AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422240",
            "telephone_number": "201-468-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIS",
        "first_name": "CATHERINE",
        "middle_name": "DOROTHY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05462800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.