Individual provider Active NPI

Irina Gorokhovskaya, LCSW

  • Clinical Social Worker
  • Manalapan, NJ
National Provider Identifier
1679245575
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06022400 Issued in NJ
Practice address
215 Shinnecock Dr
Manalapan, NJ 07726-9519
Phone
(917) 685-4863
NPI assigned
Sep 30, 2021
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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 44SC06022400 NJ Primary

Addresses

Primary practice location

215 Shinnecock Dr
Manalapan, NJ 07726-9519

Mailing address

215 Shinnecock Dr
Manalapan, NJ 07726-9519
Phone (917) 685-4863

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address igorokhovskaya@hotmail.com

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
I20211103002242 NJ Practitioner - Clinical Social Worker 2264820661 Practice locations: Manalapan, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 Shinnecock Dr
Manalapan, NJ 07726-9519
Phone (917) 685-4863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06022400NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1679245575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SHINNECOCK DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077269519",
            "telephone_number": "917-685-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SHINNECOCK DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077269519",
            "telephone_number": "917-685-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOROKHOVSKAYA",
        "first_name": "IRINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06022400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "igorokhovskaya@hotmail.com",
            "affiliation": "N",
            "address_1": "215 Shinnecock Dr",
            "city": "Manalapan",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077269519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

Verify at the official NPI Registry.