Active NPI
Pamela J Clyne, LCSW
- Clinical Social Worker
- New Egypt, NJ
National Provider Identifier
1508193475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC00480300
- Practice address
- 31 Archertown Rd
New Egypt, NJ 08533-1902 - Phone
- (732) 938-3080
- Fax
- (732) 938-3085
- NPI assigned
- Nov 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC00480300 | NJ | Primary |
Addresses
Primary practice location
31 Archertown Rd
New Egypt, NJ 08533-1902
Mailing address
PO Box 361
Allenwood, NJ 08720-0361
Phone (732) 938-3080
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC00480300 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Chemris, LCSW,LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Shore Behavioral Services
- Mental Health Counselor
- Brick, NJ
- NPI 1043304876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257984000000",
"number": "1508193475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 361",
"city": "ALLENWOOD",
"state": "NJ",
"postal_code": "087200361",
"telephone_number": "732-938-3080",
"fax_number": "732-938-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 ARCHERTOWN RD",
"city": "NEW EGYPT",
"state": "NJ",
"postal_code": "085331902",
"telephone_number": "732-938-3080",
"fax_number": "732-938-3085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLYNE",
"first_name": "PAMELA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2009-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC00480300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Egypt, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.