Active NPI
Jacqueline Koppa, LSW
- Social Worker
- Little Egg Harbor TWP, NJ
National Provider Identifier
1740012137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL07160900
- Practice address
- 590 Nugentown Rd
Little Egg Harbor TWP, NJ 08087-3905 - Phone
- (908) 313-3456
- NPI assigned
- Aug 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL07160900 | NJ | Primary |
Addresses
Primary practice location
590 Nugentown Rd
Little Egg Harbor TWP, NJ 08087-3905
Mailing address
8600 Beach Ave
Long Beach Township, NJ 08008
Phone (908) 313-3456
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL07160900 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1740012137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8600 BEACH AVE",
"city": "LONG BEACH TOWNSHIP",
"state": "NJ",
"postal_code": "08008",
"telephone_number": "908-313-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 NUGENTOWN RD",
"city": "LITTLE EGG HARBOR TWP",
"state": "NJ",
"postal_code": "080873905",
"telephone_number": "908-313-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPPA",
"first_name": "JACQUELINE",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-15",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL07160900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Egg Harbor TWP, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.