Active NPI
Integrative Support Network
- Clinical Social Worker
- Madison, NJ
National Provider Identifier
1508513003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- INTEGRATIVE SUPPORT NETWORK
- Practice address
- 214 Main St FL 2
Madison, NJ 07940-2289 - Phone
- (973) 295-0446
- NPI assigned
- Mar 4, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Walters, LCSW
- Title
- Founder
- Phone
- (973) 295-0446
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
214 Main St FL 2
Madison, NJ 07940-2289
Mailing address
214 Main St FL 2
Madison, NJ 07940-2289
Phone (973) 295-0446
Other names 1
- Jennifer Ellis Walters Psychotherapy
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | integrativesupportnetwork.org |
National Provider Directory
National Provider DirectoryLocations
214 Main St
Fl 2
Madison, NJ 07940
Phone (973) 295-0446
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": "1646352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646352000000",
"number": "1508513003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 MAIN ST FL 2",
"city": "MADISON",
"state": "NJ",
"postal_code": "079402289",
"telephone_number": "973-295-0446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 MAIN ST FL 2",
"city": "MADISON",
"state": "NJ",
"postal_code": "079402289",
"telephone_number": "973-295-0446"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRATIVE SUPPORT NETWORK",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-04",
"last_updated": "2022-03-04",
"certification_date": "2022-03-04",
"status": "A",
"authorized_official_last_name": "WALTERS",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "FOUNDER",
"authorized_official_telephone_number": "973-295-0446",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "integrativesupportnetwork.org",
"affiliation": "N",
"endpointDescription": "website",
"address_1": "214 Main St Fl 2",
"city": "Madison",
"state": "NJ",
"country_code": "US",
"postal_code": "079402289",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Jennifer Ellis Walters Psychotherapy",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Madison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.