Individual provider Active NPI

Robert David Cohen, MSW, LCSW

  • Clinical Social Worker
  • Holmdel, NJ
National Provider Identifier
1669693719
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00140400 Issued in NJ
Practice address
721 N Beers St
Suite 1a
Holmdel, NJ 07733-1518
Phone
(732) 614-7655
Fax
(732) 290-7009
NPI assigned
May 2, 2007
Sex
Male
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 44SC00140400 NJ Primary

Addresses

Primary practice location

721 N Beers St
Suite 1a
Holmdel, NJ 07733-1518

Mailing address

26 Painted Wagon Rd
Holmdel, NJ 07733-2728
Phone (732) 614-7655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160520000507 MA Practitioner - Clinical Social Worker 9537100839 Practice locations: Provincetown, MA; Wellfleet, MA; Brewster, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23 Bay State CT
Brewster, MA 02631-2120
Phone (508) 776-5301

295 Blue Heron Rd
Wellfleet, MA 02667-8227
Phone (508) 776-5301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00140400NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Forrister M.D. P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669693719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 PAINTED WAGON RD",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332728",
            "telephone_number": "732-614-7655",
            "fax_number": "732-290-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 N BEERS ST",
            "address_2": "SUITE 1A",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331518",
            "telephone_number": "732-614-7655",
            "fax_number": "732-290-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00140400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.