Individual provider Active NPI

Paige Portner, LSW

  • Social Worker
  • Clementon, NJ
National Provider Identifier
1649134826
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL06958800 Issued in NJ
Practice address
1701 Kingswood PL
Clementon, NJ 08021-5809
Phone
(609) 354-2364
NPI assigned
Dec 12, 2025
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL06958800 NJ Primary

Addresses

Primary practice location

1701 Kingswood PL
Clementon, NJ 08021-5809

Mailing address

1701 Kingswood PL
Clementon, NJ 08021-5809
Phone (609) 354-2364

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
I20260219000166 NJ Practitioner - Mental Health Counselor 1456831262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JLS Medical PCGroup PAC ID 7719342005, 53 clinicians

Practice addresses (Care Compare)

1030 Kings Hwy N
Suite 210 Mywellbrook Health
Cherry Hill, NJ 08034-1907
Phone (201) 822-1161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06958800NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
JLS Medical PC CurrentSince Feb 3, 2026 Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation Past Accepting new patients

Locations

1030 Kings Hwy N
Ste 210
Cherry Hill, NJ 08034
Phone (856) 321-1900

550 Broad St
Ste 606
Newark, NJ 07102
Phone (425) 458-8525

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1765497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1649134826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 KINGSWOOD PL",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080215809",
            "telephone_number": "609-354-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 KINGSWOOD PL",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080215809",
            "telephone_number": "609-354-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTNER",
        "first_name": "PAIGE",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-12",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06958800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clementon, NJ

Sources for this page

Verify at the official NPI Registry.