Individual provider Active NPI

Ivory Williams, LCSW

  • Clinical Social Worker
  • Passaic, NJ
National Provider Identifier
1669261970
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06397600 Issued in NJ
Practice address
85 Crescent Ave
Passaic, NJ 07055-2437
Phone
(973) 264-0023
Fax
(973) 264-0022
NPI assigned
May 2, 2025
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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 44SC06397600 NJ Primary

Addresses

Primary practice location

85 Crescent Ave
Passaic, NJ 07055-2437

Mailing address

2719 Hollywood Blvd Ste 5469
Hollywood, FL 33020-4821
Phone (973) 264-0023

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
I20250512001961 NJ Practitioner - Clinical Social Worker 1759808876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

85 Crescent Ave
Passaic, NJ 07055-2437
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06397600NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC Clinical CurrentSince Apr 1, 2025 Accepting new patients

Locations

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

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, 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": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1669261970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 HOLLYWOOD BLVD STE 5469",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204821",
            "telephone_number": "973-264-0023",
            "fax_number": "973-264-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 CRESCENT AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552437",
            "telephone_number": "973-264-0023",
            "fax_number": "973-264-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "IVORY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06397600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.