Individual provider Active NPI

Jeanne E Palazzo, LCSW

  • Clinical Social Worker
  • Ridgewood, NJ
National Provider Identifier
1740627827
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05375700 Issued in NJ
Practice address
589 Franklin Tpke
Ridgewood, NJ 07450-1989
Phone
(201) 445-4900
NPI assigned
May 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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 44SC05375700 NJ Primary

Addresses

Primary practice location

589 Franklin Tpke
Ridgewood, NJ 07450-1989

Mailing address

589 Franklin Tpke
Ridgewood, NJ 07450-1989
Phone (201) 445-4900

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
I20151116000148 NJ Practitioner - Clinical Social Worker 2567772924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center of Revitalizing Psychiatry, P.C.Group PAC ID 0648239988, 39 clinicians

Practice addresses (Care Compare)

340 W Passaic St
Suite 1
Rochelle Park, NJ 07662-3019
Phone (201) 488-5161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center of Revitalizing Psychiatry, P.C. CurrentSince Mar 18, 2016 Accepting new patients
Senior Care Therapy LLC Clinical CurrentSince Feb 8, 2016 Accepting new patients

Locations

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

795 Main St
Hackensack, NJ 07601
Phone (201) 488-5161

340 W Passaic St
Ste 1
Rochelle Park, NJ 07662
Phone (201) 488-5161

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1740627827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 FRANKLIN TPKE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501989",
            "telephone_number": "201-445-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 FRANKLIN TPKE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501989",
            "telephone_number": "201-445-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZO",
        "first_name": "JEANNE",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05375700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.