Active NPI
Soroh Wolk, LSW
- Social Worker
- Lakewood, NJ
National Provider Identifier
1750618054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05505500
- Practice address
- 700 Airport Road
Preferred Behavioral Health of NJ
Lakewood, NJ 08701 - Phone
- (732) 367-4700
- Fax
- (732) 364-2253
- NPI assigned
- Nov 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 44SL05505500 | NJ | Primary |
Addresses
Primary practice location
700 Airport Road
Preferred Behavioral Health of NJ
Lakewood, NJ 08701
Mailing address
700 Airport Road
Preferred Behavioral Health of NJ
Lakewood, NJ 08701
Phone (732) 367-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0029807 | Medicaid | NJ |
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 |
|---|---|---|---|
| 44SL05505500 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257465600000",
"number": "1750618054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 AIRPORT ROAD",
"address_2": "PREFERRED BEHAVIORAL HEALTH OF NJ",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "08701",
"telephone_number": "732-367-4700",
"fax_number": "732-364-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 AIRPORT ROAD",
"address_2": "PREFERRED BEHAVIORAL HEALTH OF NJ",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "08701",
"telephone_number": "732-367-4700",
"fax_number": "732-364-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLK",
"first_name": "SOROH",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-06",
"last_updated": "2009-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05505500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0029807",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.