Active NPI
Mary Kathleen Pettrow, BA
- Social Worker
- Whiting, NJ
National Provider Identifier
1538200993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SW00809700
- Practice address
- 88 Schoolhouse Rd
Whiting, NJ 08759-3051 - Phone
- (732) 350-2120
- Fax
- (732) 350-2725
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SW00809700 | NJ | Primary |
Addresses
Primary practice location
88 Schoolhouse Rd
Whiting, NJ 08759-3051
Mailing address
339 W Fish Rd
Jackson, NJ 08527-3126
Phone (732) 928-5189
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)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SW00809700 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538200993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 W FISH RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085273126",
"telephone_number": "732-928-5189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 SCHOOLHOUSE RD",
"city": "WHITING",
"state": "NJ",
"postal_code": "087593051",
"telephone_number": "732-350-2120",
"fax_number": "732-350-2725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTROW",
"first_name": "MARY",
"middle_name": "KATHLEEN",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SW00809700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiting, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.