Kimberly K Fazzini, LCSW
Individual provider Active NPI Clinical Social Worker · Atlantic Highlands, NJ
NPI 1376289488 · NPPES record last updated May 11, 2022
Key facts
- NPI
- 1376289488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 44SC06083800 (NJ)
- Practice address
- 20 Center Ave Ste 2
Atlantic Highlands, NJ 07716-1015 - Phone
- (732) 872-8882
- Fax
- (732) 872-7540
- NPI assigned
- May 11, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
Toms River, NJ 08753
Phone (732) 581-1046
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220712002694 | NJ | Practitioner - Clinical Social Worker | 9537549217 | Practice locations: Toms River, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC06083800 | NJ | Yes |
Addresses
Primary practice location
20 Center Ave Ste 2
Atlantic Highlands, NJ 07716-1015
Mailing address
20 Center Ave Ste 2
Atlantic Highlands, NJ 07716-1015
Phone (732) 872-8882
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.seniorcareoptionsinc.com | Direct |
Other providers in Atlantic Highlands, NJ
- Elaine Marie Egidio
- Brandon W English
- Alison McClellan Evans
- Evolve Occupational Therapy
- Jennifer Higgins Factor
- Tina F Fidalgo
- First Call Health, LLC
- First Call Ppe LLC
- Five Star Day Care
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All providers in Atlantic Highlands, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.