Individual provider Active NPI

Kristina E Pilgrim, L.C.S.W

  • Mental Health Counselor
  • Red Bank, NJ
National Provider Identifier
1578800942
Registry record updated Jan 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC05380200 Issued in NJ
Practice address
47 Reckless PL
Red Bank, NJ 07701-1750
Phone
(908) 415-6941
NPI assigned
Jan 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SC05380200 NJ Primary

Addresses

Primary practice location

47 Reckless PL
Red Bank, NJ 07701-1750

Mailing address

105 Manor Dr
Red Bank, NJ 07701-2463
Phone (908) 415-6941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230512001954 NJ Practitioner - Clinical Social Worker 4587020771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 Maple Ave
Suite 202
Red Bank, NJ 07701-1715
Phone (908) 415-6941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kristina Pilgrim LCSW LLC Mental Health CurrentSince Dec 24, 2022 Accepting new patients

Locations

103 Maple Ave
Ste 202
Red Bank, NJ 07701
Phone (732) 523-4345

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": "1357344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357344000000",
    "number": "1578800942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MANOR DR",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012463",
            "telephone_number": "908-415-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 RECKLESS PL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011750",
            "telephone_number": "908-415-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILGRIM",
        "first_name": "KRISTINA",
        "middle_name": "E",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-05",
        "last_updated": "2013-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05380200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.