Individual provider Active NPI

Johanna Cohen, L.C.S.W.

  • Clinical Social Worker
  • Elizabeth, NJ
National Provider Identifier
1710116553
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05377500 Issued in NJ
Practice address
230 W Jersey St Ste 104
Elizabeth, NJ 07202-1352
Phone
(908) 469-9440
NPI assigned
Jul 14, 2009
Last updated
Jun 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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 44SC05377500 NJ Primary

Addresses

Primary practice location

230 W Jersey St Ste 104
Elizabeth, NJ 07202-1352

Mailing address

866 Salem Ave
Hillside, NJ 07205-3035
Phone (908) 943-7641

Other practice location 1

866 Salem Ave
Hillside, NJ 07205-3035
Phone (908) 943-7641

Other practice location 2

275 Hobart St
Perth Amboy, NJ 08861-4310
Phone (732) 376-9333 ext. 6635

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
I20190918002634 NJ Practitioner - Clinical Social Worker 6204166283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

85 Crescent Ave
Passaic, NJ 07055-2437
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05377500NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC Clinical CurrentSince Nov 1, 2022 Accepting new patients
Supportive Care Psychology of NJ PC CurrentSince Aug 1, 2019 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

560 Berkeley Ave
Orange, NJ 07050
Phone (973) 672-6500

231 Warner St
Toms River, NJ 08755
Phone (732) 942-0800

Organizations & group practices 2

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1710116553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 SALEM AVE",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "072053035",
            "telephone_number": "908-943-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W JERSEY ST STE 104",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021352",
            "telephone_number": "908-469-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "866 Salem Ave",
            "address_purpose": "LOCATION",
            "city": "Hillside",
            "state": "NJ",
            "postal_code": "072053035",
            "country_code": "US",
            "telephone_number": "908-943-7641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088614310",
            "country_code": "US",
            "telephone_number": "732-376-9333 x6635",
            "fax_number": "732-324-5765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JOHANNA",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05377500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.