Individual provider Active NPI

Heather Rafanello, MSW, LCSW

  • Social Worker
  • Brick, NJ
National Provider Identifier
1659860377
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL06197700 Issued in NJ
Practice address
10 Sunset CT
Brick, NJ 08723-5488
Phone
(201) 400-4041
NPI assigned
May 8, 2018
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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 44SL06197700 NJ Primary

Addresses

Primary practice location

10 Sunset CT
Brick, NJ 08723-5488

Mailing address

15000 Midlantic Dr Ste 101
Mount Laurel, NJ 08054-1573
Phone (856) 380-2760

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
I20190703002132 NJ Practitioner - Clinical Social Worker 9032444526 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06197700NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Mindset Therapy LLC CurrentSince Jul 4, 2021 Accepting new patients

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1659860377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 MIDLANTIC DR STE 101",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541573",
            "telephone_number": "856-380-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SUNSET CT",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087235488",
            "telephone_number": "201-400-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFANELLO",
        "first_name": "HEATHER",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06197700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.