Individual provider Active NPI

Maria A Santiago, LCSW

  • Clinical Social Worker
  • Elizabeth, NJ
National Provider Identifier
1447731005
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05629300 Issued in NJ
Practice address
654 E Jersey St
Elizabeth, NJ 07206-1261
Phone
(908) 994-7150
Fax
(908) 994-7054
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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 44SC05629300 NJ Primary

Addresses

Primary practice location

654 E Jersey St
Elizabeth, NJ 07206-1261

Mailing address

654 E Jersey St
Elizabeth, NJ 07206-1261
Phone (900) 994-7150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05629300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Blom LCSW LLC PastSince Oct 5, 2018 Accepting new patients
Kristin Korab-Reynolds LLC PastSince Feb 1, 2023 Accepting new patients

Organizations & group practices 2

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1447731005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061261",
            "telephone_number": "900-994-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061261",
            "telephone_number": "908-994-7150",
            "fax_number": "908-994-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "MARIA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05629300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.