Individual provider Active NPI

Amy L Dorfman, LCSW

  • Mental Health Counselor
  • Marlboro, NJ
National Provider Identifier
1376570200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SC05806 Issued in NJ
Practice address
21 Cannonade Dr
Marlboro, NJ 07746-1937
Phone
(732) 577-8982
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SC05806 NJ Primary

Addresses

Primary practice location

21 Cannonade Dr
Marlboro, NJ 07746-1937

Mailing address

21 Cannonade Dr
Marlboro, NJ 07746-1937
Phone (732) 577-8982

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
I20050505000017 NJ Practitioner - Clinical Social Worker 0840230231 Practice locations: Manalapan, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

32 Palamino Dr
Manalapan, NJ 07726-9583
Phone (908) 770-4715

32 Palomino Dr
Manalapan, NJ 07726-9583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC05806NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family & Children'S Service of Greater Monmouth County PastSince May 9, 2007 Accepting new patients

Organizations & group practices 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376570200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CANNONADE DR",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461937",
            "telephone_number": "732-577-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CANNONADE DR",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461937",
            "telephone_number": "732-577-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFMAN",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "SC05806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlboro, NJ

Sources for this page

Verify at the official NPI Registry.