Individual provider Active NPI

Mary Margaret Brereton, LCSW

  • Clinical Social Worker
  • Cranford, NJ
National Provider Identifier
1457579948
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05382800 Issued in NJ
Practice address
113 Lincoln Ave E
Cranford, NJ 07016-2820
Phone
(973) 580-5653
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05382800 NJ Primary
Clinical Social Worker 1041C0700X 077219-1 NY

Addresses

Primary practice location

113 Lincoln Ave E
Cranford, NJ 07016-2820

Mailing address

113 Lincoln Ave E
Cranford, NJ 07016-2820
Phone (973) 580-5653

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
I20250109000598 NJ Practitioner - Clinical Social Worker 5294263927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifebulb LLCGroup PAC ID 2062881162, 97 clinicians

Practice addresses (Care Compare)

505 Main St
Toms River, NJ 08753-7443
Phone (732) 272-0127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077219-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebulb LLC CurrentSince Nov 8, 2024 Accepting new patients
Thrive Counseling LLC CurrentSince Nov 8, 2024 Accepting new patients

Locations

3 Lincoln Hwy
Ste 102A
Edison, NJ 08820

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1457579948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LINCOLN AVE E",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162820",
            "telephone_number": "973-580-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LINCOLN AVE E",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162820",
            "telephone_number": "973-580-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRERETON",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05382800",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077219-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranford, NJ

Sources for this page

Verify at the official NPI Registry.