Kevin Nussbaum, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL05153000 Issued in NJ

Practice address

2117 3Rd Ave
Toms River, NJ 08757-3610

Phone

(908) 783-8778

NPI assigned

Jan 16, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Kevin Nusbaum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1366157174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 3RD AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087573610",
            "telephone_number": "908-783-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 3RD AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087573610",
            "telephone_number": "908-783-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05153000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "NUSBAUM",
            "prefix": "MR.",
            "credential": "LSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Social Worker in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.