Individual provider Active NPI

Marysue McNair, LCSW

  • Clinical Social Worker
  • Iselin, NJ
National Provider Identifier
1639284227
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC001862000 Issued in NJ
Practice address
11 Nimitz PL
Iselin, NJ 08830-2329
Phone
(732) 636-5414
Fax
(732) 636-5414
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 44SC001862000 NJ Primary

Addresses

Primary practice location

11 Nimitz PL
Iselin, NJ 08830-2329

Mailing address

11 Nimitz PL
Iselin, NJ 08830-2329
Phone (732) 636-5414

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
I20061128000490 NJ Practitioner - Clinical Social Worker 1759387517 Practice locations: Iselin, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Nimitz PL
Iselin, NJ 08830-2329
Phone (732) 636-5414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC001862000NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639284227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NIMITZ PL",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302329",
            "telephone_number": "732-636-5414",
            "fax_number": "732-636-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NIMITZ PL",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302329",
            "telephone_number": "732-636-5414",
            "fax_number": "732-636-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAIR",
        "first_name": "MARYSUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC001862000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iselin, NJ

Sources for this page

Verify at the official NPI Registry.