Licia A Nusbaum-Brannigan, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL05919000 Issued in NJ

Practice address

103 Crabapple LN
Franklin Park, NJ 08823-1419

Phone

(845) 304-7194

NPI assigned

Oct 1, 2015

Last updated

Oct 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1538539648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CRABAPPLE LN",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231419",
            "telephone_number": "845-304-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CRABAPPLE LN",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231419",
            "telephone_number": "845-304-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSBAUM-BRANNIGAN",
        "first_name": "LICIA",
        "middle_name": "A",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL05919000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhanuprakash Mamidi
• Anne-Marie Marange, NASM- CPT
• Aditi Mehta, DPT
• Mahjabeen Motiwala, PHARMD
• New Jersey CVS Pharmacy LLC (CVS Pharmacy 00936)
• Nutrition by Rawan LLC
• Sue Lynne Oliveira, LPC
• Kayode G Olubajo
• Jane Owusu
• Ami T Patel, FNP

• Clinical Social Worker in Franklin Park, NJ
• Providers in Franklin Park, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.