Individual provider Active NPI

Sidsel Venger, LCSW

  • Clinical Social Worker
  • Newark, NJ
National Provider Identifier
1407303514
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
445C01276400 Issued in NJ
Practice address
393 Central Ave
Newark, NJ 07103-2842
Phone
(973) 483-3444
Fax
(973) 485-7080
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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 445C01276400 NJ Primary

Addresses

Primary practice location

393 Central Ave
Newark, NJ 07103-2842

Mailing address

393 Central Ave
Newark, NJ 07103-2842
Phone (973) 483-3444

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
445C01276400NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1407303514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032842",
            "telephone_number": "973-483-3444",
            "fax_number": "973-485-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032842",
            "telephone_number": "973-483-3444",
            "fax_number": "973-485-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENGER",
        "first_name": "SIDSEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "445C01276400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.