Individual provider Active NPI

Gwyn Sondike

  • Clinical Social Worker
  • Mendham, NJ
National Provider Identifier
1679901029
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05688800 Issued in NJ
Practice address
80 W Main St
Mendham, NJ 07945-1257
Phone
(973) 543-5656
Fax
(973) 543-1361
NPI assigned
Oct 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00252400 NJ
Behavior Analyst 103K00000X
Clinical Social Worker 1041C0700X 44SC05688800 NJ Primary

Addresses

Primary practice location

80 W Main St
Mendham, NJ 07945-1257

Mailing address

80 W Main St
Mendham, NJ 07945-1257
Phone (973) 543-5656

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
I20170731000398 NJ Practitioner - Clinical Social Worker 3779854419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neuropsychology and Counseling Associates, LLCGroup PAC ID 4880689298, 15 clinicians

Practice addresses (Care Compare)

1683 Route 88
Suite a
Brick, NJ 08724-3072
Phone (732) 840-5266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00252400NJMDAddiction (Substance Use Disorder) Counselor
44SC05688800NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology & Counseling Associates, LLC CurrentSince Jun 17, 2017 Accepting new patients

Locations

1683 Route 88 W
Ste A
Brick, NJ 08724
Phone (732) 840-5266

4 Paragon Way
Ste 350
Freehold, NJ 07728
Phone (212) 262-0741

3820 River Rd
Point Pleasant Boro, NJ 08742
Phone (732) 840-5266

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1679901029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451257",
            "telephone_number": "973-543-5656",
            "fax_number": "973-543-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 W MAIN ST",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451257",
            "telephone_number": "973-543-5656",
            "fax_number": "973-543-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONDIKE",
        "first_name": "GWYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00252400",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05688800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendham, NJ

Sources for this page

Verify at the official NPI Registry.