Individual provider Active NPI

Kathy Marie Ryan, MSW, LCSW

  • Clinical Social Worker
  • Pennington, NJ
National Provider Identifier
1457543043
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00286500 Issued in NJ
Practice address
106 W Franklin Ave
Suite F122
Pennington, NJ 08534-1449
Phone
(609) 466-9898
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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 44SC00286500 NJ Primary

Addresses

Primary practice location

106 W Franklin Ave
Suite F122
Pennington, NJ 08534-1449

Mailing address

106 W Franklin Ave
Suite F122
Pennington, NJ 08534-1449
Phone (609) 466-9898

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090623000337 NJ Practitioner - Clinical Social Worker 9830240308 Practice locations: Pennington, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

106 W Franklin Ave
Suite F 122
Pennington, NJ 08534-1449
Phone (609) 466-9898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1457543043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W FRANKLIN AVE",
            "address_2": "SUITE F122",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341449",
            "telephone_number": "609-466-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W FRANKLIN AVE",
            "address_2": "SUITE F122",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341449",
            "telephone_number": "609-466-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KATHY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00286500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.