Laurel Rhona Fastow

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC00597000 Issued in NJ

Practice address

76 S Orange Ave Ste 214
South Orange, NJ 07079-1923

Phone

(973) 704-4657

NPI assigned

Feb 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jespy HouseGroup PAC ID 8426481995, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Jespy House

  • Developmentally Disabled Services Day Training Agency
  • South Orange, NJ
  • NPI 1144565581
  Medicare reassignment Care Compare group NPD
• Jespy House

  • Clinical Social Worker
  • South Orange, NJ
  • NPI 1326851247
  NPD

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1710740659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 S ORANGE AVE STE 214",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791923",
            "telephone_number": "973-704-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 S ORANGE AVE STE 214",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791923",
            "telephone_number": "973-704-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASTOW",
        "first_name": "LAUREL",
        "middle_name": "RHONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00597000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Adult Care LLC
• Exclusive Oral Surgery
• Family Connections, Inc.
• Family Intervention Services Inc
• Anne E. Faraher, BCBA
• Daniel Robert Fawcett, NP STUDENT
• Javier Ferrandiz, PA-C
• Alicia Marie Ferriere, P.T., D.P.T.
• Final Stop Family Services
• First Help Home Aide Care LLC

• Clinical Social Worker in South Orange, NJ
• Providers in South Orange, 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 Apr 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.