Individual provider Active NPI

Barbara Campbell-Antoine, LCSW

  • Clinical Social Worker
  • Matawan, NJ
National Provider Identifier
1366695249
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006388 Issued in GA
Practice address
199 Main St
Suite 8
Matawan, NJ 07747-3187
Phone
(732) 332-8113
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC04819900 NJ
Clinical Social Worker 1041C0700X CSW006388 GA Primary

Addresses

Primary practice location

199 Main St
Suite 8
Matawan, NJ 07747-3187

Mailing address

199 Main St
Suite 8
Matawan, NJ 07747-3187
Phone (732) 332-8113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200728001959 GA Practitioner - Clinical Social Worker 7618391376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

1510 Klondike Rd SW
Suite 301
Conyers, GA 30094-5121
Phone (770) 648-1308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04819900NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Aug 1, 2021 Accepting new patients
Rebecca'S Hope Therapy Past Accepting new patients

Locations

1510 Klondike Rd SW
Ste 301
Conyers, GA 30094

1808 Over Lake Dr SE
Ste D
Conyers, GA 30013
Phone (770) 648-1308

4255 Wade Green Rd NW
Ste 414
Kennesaw, GA 30144
Phone (678) 439-9952

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.barbaraantoine@124220.advancedmd-direct.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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1366695249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 MAIN ST",
            "address_2": "SUITE 8",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473187",
            "telephone_number": "732-332-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 MAIN ST",
            "address_2": "SUITE 8",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473187",
            "telephone_number": "732-332-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL-ANTOINE",
        "first_name": "BARBARA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04819900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

Verify at the official NPI Registry.