Individual provider Active NPI

Emil Reyes Brito, LSW

  • Social Worker
  • Fair Lawn, NJ
National Provider Identifier
1740002427
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL07211600 Issued in NJ
Practice address
22-08 Route 208 Ste 16
Fair Lawn, NJ 07410-2609
Phone
(201) 956-6363
NPI assigned
Oct 24, 2024
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL07211600 NJ Primary

Addresses

Primary practice location

22-08 Route 208 Ste 16
Fair Lawn, NJ 07410-2609

Mailing address

102 Marble CT
Milford, PA 18337-4350
Phone (845) 551-2651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SL07211600NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellsprings Counseling Center, LLC CurrentSince Oct 27, 2024 Accepting new patients

Locations

22-08 State Rt 208
Ste 16
Fair Lawn, NJ 07410
Phone (201) 956-6363

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": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1740002427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MARBLE CT",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183374350",
            "telephone_number": "845-551-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-08 ROUTE 208 STE 16",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102609",
            "telephone_number": "201-956-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES BRITO",
        "first_name": "EMIL",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL07211600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.