Elena Theresa Mazza, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04785100 Issued in NJ

Practice address

268 Broad Street
Red Bank, NJ 07701-2042

Phone

(732) 663-1344

Fax

(732) 663-1334

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2008.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1679517890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077010129",
            "telephone_number": "732-663-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 BROAD STREET",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012042",
            "telephone_number": "732-663-1344",
            "fax_number": "732-663-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "ELENA",
        "middle_name": "THERESA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04785100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P2458807",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "27135400",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019810",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen K Gallagher
• Maureen V Waters LCSW LLC
• Brittany Mauro, APN
• Anthony T Mayers, PT, DPT
• Thomas Mazorlig, L.AC.
• Grace Marie Mazzatta, APN
• Christopher Michael McCaffrey
• Debra A. McCann-Call, MSW, LCSW
• Marissa McCarthy Canonico, LSW
• Christine Marie McCarthy, M.S., OTR/L

• All providers in Red Bank, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.