Individual provider Active NPI

Angelo Fouras, LCSW

  • Clinical Social Worker
  • East Brunswick, NJ
National Provider Identifier
1669852075
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05659300 Issued in NJ
Practice address
288 Rues LN
East Brunswick, NJ 08816-5699
Phone
(732) 257-6100
NPI assigned
Jun 2, 2015
Last updated
Nov 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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 44SC05659300 NJ Primary

Addresses

Primary practice location

288 Rues LN
East Brunswick, NJ 08816-5699

Mailing address

49 Park Ave
Iselin, NJ 08830-2241
Phone (732) 887-9208

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
I20160127000228 NJ Practitioner - Clinical Social Worker 0840593703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifebulb LLCGroup PAC ID 2062881162, 97 clinicians

Practice addresses (Care Compare)

505 Main St
Toms River, NJ 08753-7443
Phone (732) 272-0127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05659300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebulb LLC CurrentSince Jan 1, 2023 Accepting new patients
Thrive Counseling LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

3 Lincoln Hwy
Ste 102A
Edison, NJ 08820

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1669852075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 PARK AVE",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302241",
            "telephone_number": "732-887-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 RUES LN",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165699",
            "telephone_number": "732-257-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURAS",
        "first_name": "ANGELO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05659300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.