Kellen Polito

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06257500 Issued in NJ

Practice address

119 Avenue at the CMN Ste 5
Shrewsbury, NJ 07702-4586

Phone

(609) 388-8701

NPI assigned

Feb 24, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1417603853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FLINTLOCK DR",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077311623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 AVENUE AT THE CMN STE 5",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024586",
            "telephone_number": "609-388-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "KELLEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06257500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellen.polito@thetherapyinstitutenj.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email Account",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Email Account",
            "address_1": "119 Avenue At The Cmn Ste 5",
            "city": "Shrewsbury",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077024586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Social Worker in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.