Woodmere Psychotherapy Associates LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WOODMERE PSYCHOTHERAPY ASSOCIATES LLC

Practice address

34 Mayhew Dr
South Orange, NJ 07079-1211

Phone

(646) 265-3634

NPI assigned

Aug 27, 2024

Last updated

Aug 27, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sean Michael Gilligan, LCSWNPI 1679917173

Title

Ceo

Phone

(646) 265-3634

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sean M Gilligan, LCSW

  • Clinical Social Worker
  • South Orange, NJ
  • NPI 1679917173
  NPD Authorized official

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1679307391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MAYHEW DR",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791211",
            "telephone_number": "646-265-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MAYHEW DR",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791211",
            "telephone_number": "646-265-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODMERE PSYCHOTHERAPY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "GILLIGAN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-265-3634",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in South Orange, NJ
• Providers in South Orange, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.