Brooke Alyson Gottheimer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05868300 Issued in NJ

Practice address

124 Timberhill Dr
East Hanover, NJ 07936-3336

Phone

(201) 919-0067

NPI assigned

Aug 13, 2012

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1720335409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 TIMBERHILL DR",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363336",
            "telephone_number": "201-919-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 TIMBERHILL DR",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363336",
            "telephone_number": "201-919-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTHEIMER",
        "first_name": "BROOKE",
        "middle_name": "ALYSON",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05868300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirag A Gandhi, DPT
• Jinesh Gandhi
• Ma Luisa Alviz Gangcuangco, OTR/L
• Emily Gencarelli, MA
• James D Girardy, MD
• John Joseph Graeber, DMD
• Nancy Jean Grande, M.D.
• Todd Allen Gruber, M.D., M.P.H.
• Taylor Hall
• Joyce LK Halper, O.D.

• Clinical Social Worker in East Hanover, NJ
• Providers in East Hanover, 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 Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.