Individual provider Active NPI

Stephanie Rose Fegan

  • Clinical Social Worker
  • Neptune, NJ
National Provider Identifier
1477022879
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05719200 Issued in NJ
Practice address
19 Commons Dr
Neptune, NJ 07753-3267
Phone
(201) 739-0656
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X NJ
Clinical Social Worker 1041C0700X 44SC05719200 NJ Primary

Addresses

Primary practice location

19 Commons Dr
Neptune, NJ 07753-3267

Mailing address

19 Commons Dr
Neptune, NJ 07753-3267
Phone (201) 739-0656

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
44SC05719200NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1477022879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 COMMONS DR",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077533267",
            "telephone_number": "201-739-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 COMMONS DR",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077533267",
            "telephone_number": "201-739-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEGAN",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05719200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.