Individual provider Active NPI

Mitchann Smoyak, LSW

  • Social Worker
  • Brick, NJ
National Provider Identifier
1558622688
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL05906600 Issued in NJ
Practice address
270 Drum Point Rd
Brick, NJ 08723-6376
Phone
(848) 232-8040
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL05906600 NJ Primary
Marriage & Family Therapist 106H00000X 44SL05906600 NJ
Counselor 101Y00000X 44SL05906600 NJ
Cognitive & Behavioral Psychologist 103TB0200X 44SL05906600 NJ
Family Psychologist 103TF0000X 44SL05906600 NJ
Social Worker 104100000X 44SW05306000 NJ

Addresses

Primary practice location

270 Drum Point Rd
Brick, NJ 08723-6376

Mailing address

PO Box 1926
Brick, NJ 08723-1071
Phone (848) 232-8040

Other identifiers 1

IdentifierTypeStateIssuer
1558622688OtherNJNPPES

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

State licenses

LicenseStateTypeSpecialty
44SL05906600NJMDCognitive & Behavioral Psychologist
44SW05306000NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adults & Children Behavioral Counseling Center LLC Marriage & Family Therapist CurrentSince Apr 25, 2021 Accepting new patients

Locations

2211 Route 88 E
Ste 2B
Brick, NJ 08724
Phone (732) 903-2222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1558622688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1926",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087231071",
            "telephone_number": "848-232-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 DRUM POINT RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236376",
            "telephone_number": "848-232-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOYAK",
        "first_name": "MITCHANN",
        "name_prefix": "Ms.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05906600",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "44SL05906600",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "44SL05906600",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NJ",
            "license": "44SL05906600",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NJ",
            "license": "44SL05906600",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SW05306000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1558622688",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.