Individual provider Active NPI

Nechama Kruk, LCSW

  • Clinical Social Worker
  • Lakewood, NJ
National Provider Identifier
1750768008
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05581800 Issued in NJ
Practice address
35 Kingsfield Dr
Lakewood, NJ 08701-3090
Phone
(732) 330-5403
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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 44SC05581800 NJ Primary

Addresses

Primary practice location

35 Kingsfield Dr
Lakewood, NJ 08701-3090

Mailing address

35 Kingsfield Dr
Lakewood, NJ 08701-3090
Phone (732) 330-5403

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
44SC05581800NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive NJ LLC Clinical PastSince Oct 31, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1750768008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 KINGSFIELD DR",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013090",
            "telephone_number": "732-330-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 KINGSFIELD DR",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013090",
            "telephone_number": "732-330-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUK",
        "first_name": "NECHAMA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05581800",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 29, 2016; 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.