Individual provider Active NPI

Katherine Pines, LCSW

  • Clinical Social Worker
  • Ridgewood, NJ
National Provider Identifier
1417514043
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05846600 Issued in NJ
Practice address
162 E Ridgewood Ave Ste 2
Ridgewood, NJ 07450-3846
Phone
(201) 540-8518
NPI assigned
May 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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 44SC05846600 NJ Primary

Addresses

Primary practice location

162 E Ridgewood Ave Ste 2
Ridgewood, NJ 07450-3846

Mailing address

162 E Ridgewood Ave Ste 2
Ridgewood, NJ 07450-3846
Phone (201) 540-8518

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
44SC05846600NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1417514043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 E RIDGEWOOD AVE STE 2",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503846",
            "telephone_number": "201-540-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 E RIDGEWOOD AVE STE 2",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503846",
            "telephone_number": "201-540-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINES",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05846600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.