Individual provider Active NPI

Jeffrey Thoelen

  • Clinical Social Worker
  • Flanders, NJ
National Provider Identifier
1508444977
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05964000 Issued in NJ
Practice address
16 Ledgewood Rd
Flanders, NJ 07836-9428
Phone
(973) 229-4976
NPI assigned
Mar 29, 2021
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 44SC05964000 NJ Primary

Addresses

Primary practice location

16 Ledgewood Rd
Flanders, NJ 07836-9428

Mailing address

16 Ledgewood Rd
Flanders, NJ 07836-9428
Phone (973) 229-4976

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
I20210602000050 NJ Practitioner - Clinical Social Worker 2769881317 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 Front St
Suite 300
Jupiter, FL 33477-5095

16 Ledgewood Rd
Flanders, NJ 07836-9428

425 E 58TH St
Suite 41F
New York, NY 10022-2379

505 Main St
Toms River, NJ 08753-7443

5838 Edison PL
Suite 100
Carlsbad, CA 92008-5520

66 E Flagler St
Miami, FL 33130-1807

85 Crescent Ave
Passaic, NJ 07055-2437

94 Wanaque Ave
Pompton Lake, NJ 07442-2075

9901 Brodie Lane
Suite 160 1077
Austin, TX 78748-5892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05964000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Living Behavioral Health LCSW PLLC Clinical CurrentSince Mar 1, 2022 Accepting new patients
Thrive Counseling LLC CurrentSince Jun 6, 2024 Accepting new patients
Senior Care Therapy LLC Clinical CurrentSince Aug 1, 2022 Accepting new patients
Talkspace Behavioral Health Services NJ, PC CurrentSince Mar 31, 2024 Accepting new patients
Lifebulb LLC CurrentSince Jun 6, 2024 Accepting new patients
Grow Healthcare Group of New Jersey PC Clinical CurrentSince Jun 6, 2024 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

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

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Organizations & group practices 8

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1508444977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 LEDGEWOOD RD",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369428",
            "telephone_number": "973-229-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 LEDGEWOOD RD",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369428",
            "telephone_number": "973-229-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOELEN",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05964000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flanders, NJ

Sources for this page

Verify at the official NPI Registry.