Gloria Servakh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL06169300 Issued in NJ

Practice address

660 Tennent Rd Ste 209
Manalapan, NJ 07726-3163

Phone

(732) 351-0411

Fax

(732) 358-0811

NPI assigned

Jan 31, 2018

Last updated

May 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Gloria Mezheritsky Former name

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Essential Counseling Therapy Services, LLCGroup PAC ID 8224459425, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Essential Counseling Therapy Services, LLC

  • Clinical Social Worker
  • Manalapan, NJ
  • NPI 1366065740
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1417455767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 TENNENT RD STE 209",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263163",
            "telephone_number": "732-351-0411",
            "fax_number": "732-358-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 TENNENT RD STE 209",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263163",
            "telephone_number": "732-351-0411",
            "fax_number": "732-358-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVAKH",
        "first_name": "GLORIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06169300",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05833600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "essentialtherapynj.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "660 Tennent Rd Ste 209",
            "city": "Manalapan",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077263163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "MEZHERITSKY",
            "credential": "MA, MSW, LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gina Marie Sefershayan
• Christine Seidman, LSW
• Mary Catherine Sens-Azara, BCBA
• Serenium Therapy and Wellness
• Serv Achievement Centers, Inc
• Rebecca Annabel Sgro, LPC
• Ajit S Shah, RPH
• Himani A Shah, P.T
• Hinna Ehsanullah Shah, M.D.
• Krishna Shah

• Clinical Social Worker in Manalapan, NJ
• Providers in Manalapan, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.