Christina Lee Van Jura, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05416800 Issued in NJ

Practice address

17 Roosevelt St
Roseland, NJ 07068-1258

Phone

(862) 345-6105

NPI assigned

Dec 27, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Montclair Hospital LLC

  • Adult Mental Health Clinic/Center
  • Montclair, NJ
  • NPI 1386893659
  Medicare reassignment NPD
• Montclair Hospital LLC

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  NPD

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1679877179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ROOSEVELT ST",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ROOSEVELT ST",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681258",
            "telephone_number": "862-345-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN JURA",
        "first_name": "CHRISTINA",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "011256",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05416800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Childrens Source for Therapy LLC
• Thrive Homes New Jersey Inc.
• Yimin Tian
• Julie Ann Traupman, APN
• Carol Tudor, LPC
• So-Young Vandergast
• Eileen Vider, MS, RDN
• Steven Alan Wahl, DPM
• Walgreen Co
• Melissa N Waton-Cohen, MT-BC

• Clinical Social Worker in Roseland, NJ
• Providers in Roseland, 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 Jan 18, 2023; 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.