Individual provider Active NPI

Michael Guglielmino, LCSW

  • Clinical Social Worker
  • Bloomfield, NJ
National Provider Identifier
1689646747
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00404600 Issued in NJ
Practice address
8 Gordon CT
Bloomfield, NJ 07003-5309
Phone
(973) 818-4561
Fax
(973) 338-0262
NPI assigned
Feb 3, 2006
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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 44SC00404600 NJ Primary

Addresses

Primary practice location

8 Gordon CT
Bloomfield, NJ 07003-5309

Mailing address

8 Gordon CT
Bloomfield, NJ 07003-5309
Phone (973) 818-4561

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
I20040329000272 NJ Practitioner - Clinical Social Worker 4688566201 Reassigns benefits to 1 organization
Practice locations: Bloomfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8 Gordon CT
Bloomfield, NJ 07003-5309
Phone (973) 818-4561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00404600NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Labyrinth Psychiatry Group LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

11 Commerce Dr
Lbby
Cranford, NJ 07016
Phone (908) 336-1187

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1689646747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GORDON CT",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035309",
            "telephone_number": "973-818-4561",
            "fax_number": "973-338-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GORDON CT",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035309",
            "telephone_number": "973-818-4561",
            "fax_number": "973-338-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGLIELMINO",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00404600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.