Individual provider Active NPI

Deborah Max

  • Clinical Social Worker
  • Jersey City, NJ
National Provider Identifier
1518786771
Registry record updated Oct 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14071 Issued in CT
Practice address
35 Waverly St Apt 4
Jersey City, NJ 07306-1000
Phone
(201) 702-6010
NPI assigned
Oct 5, 2024
Last updated
Oct 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2024

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 14071 CT Primary

Addresses

Primary practice location

35 Waverly St Apt 4
Jersey City, NJ 07306-1000

Mailing address

35 Waverly St Apt 4
Jersey City, NJ 07306-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241030002628 CT Practitioner - Clinical Social Worker 7517490477 Reassigns benefits to 1 organization
I20250211003342 NJ Practitioner - Clinical Social Worker 7517490477 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14071CTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Sep 25, 2024 Accepting new patients
Grow Healthcare Group of New Jersey PC Clinical CurrentSince Jan 17, 2025 Accepting new patients

Locations

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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

Organizations & group practices 2

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": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1518786771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WAVERLY ST APT 4",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WAVERLY ST APT 4",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061000",
            "telephone_number": "201-702-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAX",
        "first_name": "DEBORAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "14071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.