Individual provider Active NPI

Megan Marie Breeman, LCSW

  • Clinical Social Worker
  • Bloomfield, NJ
National Provider Identifier
1619542438
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06300500 Issued in NJ
Practice address
10 Bukowski PL Apt 4
Bloomfield, NJ 07003-5234
Phone
(551) 206-3883
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06300500 NJ Primary

Addresses

Primary practice location

10 Bukowski PL Apt 4
Bloomfield, NJ 07003-5234

Mailing address

10 Bukowski PL Apt 4
Bloomfield, NJ 07003-5234
Phone (551) 206-3883

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
I20240122004397 NJ Practitioner - Clinical Social Worker 1557713872 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC Clinical CurrentSince Jan 1, 2024 Accepting new patients
TMR Mental Health Care PC Clinical CurrentSince Jul 8, 2024 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

861 Main St
#1
Hackensack, NJ 07601
Phone (201) 528-5757

861 Main St
Hackensack, NJ 07601
Phone (201) 212-5733

Organizations & group practices 2

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": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1619542438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BUKOWSKI PL APT 4",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035234",
            "telephone_number": "551-206-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BUKOWSKI PL APT 4",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035234",
            "telephone_number": "551-206-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEMAN",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06300500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.