Organization Active NPI

Grace Recovery Center

  • Clinical Social Worker
  • Wayne, NJ
National Provider Identifier
1477025534
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GRACE RECOVERY CENTER
Practice address
40 Galesi Dr Ste 26
Wayne, NJ 07470-4841
Phone
(973) 769-3699
NPI assigned
Dec 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Authorized official

Name
Lashone Arnett, LCSWNPI 1407204415
Title
Owner
Phone
(973) 769-3699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

40 Galesi Dr Ste 26
Wayne, NJ 07470-4841

Mailing address

52 Elberon Ave
Paterson, NJ 07502-2025
Phone (973) 769-3699

Other identifiers 1

IdentifierTypeStateIssuer
1407204415MedicaidNJ

National Provider Directory

National Provider Directory

Locations

40 Galesi Dr
Ste 26
Wayne, NJ 07470
Phone (973) 602-7949

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1477025534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 ELBERON AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075022025",
            "telephone_number": "973-769-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GALESI DR STE 26",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704841",
            "telephone_number": "973-769-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "ARNETT",
        "authorized_official_first_name": "LASHONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-769-3699",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407204415",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.