Tailored for Change, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC0537200 Issued in NJ

Legal business name

TAILORED FOR CHANGE, LLC

Practice address

400 38TH Street
210
Union City, NJ 07087

Phone

(917) 518-1075

NPI assigned

Dec 10, 2015

Last updated

Jul 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Nancy Andino, LCSW

Title

Founder; Ceo

Phone

(917) 518-1075

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1558736942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 38TH STREET",
            "address_2": "SUITE 210",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "917-518-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 38TH STREET",
            "address_2": "210",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "917-518-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAILORED FOR CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "ANDINO",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "FOUNDER; CEO",
        "authorized_official_telephone_number": "917-518-1075",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC0537200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Union City, NJ
• Providers in Union City, 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 Jul 14, 2016; 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.