Individual provider Active NPI

Gerard M Lagos, LCSW

  • Clinical Social Worker
  • North Haledon, NJ
National Provider Identifier
1760676225
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04583300 Issued in NJ
Practice address
886 Belmont Ave
North Haledon, NJ 07508-2573
Phone
(973) 423-3983
Fax
(201) 485-8241
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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 44SC04583300 NJ Primary

Addresses

Primary practice location

886 Belmont Ave
North Haledon, NJ 07508-2573

Mailing address

886 Belmont Ave
North Haledon, NJ 07508-2573
Phone (973) 423-3983

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
I20050411001021 NJ Practitioner - Clinical Social Worker 5294772331 Practice locations: Wyckoff, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Wyckoff, NJ 07481
Phone (551) 804-1284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04583300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Care Management and Counseling, LLC PastSince Feb 14, 2012 Accepting new patients
Don Digiovine, PH.D. LLC Past Accepting new patients

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1760676225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 BELMONT AVE",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082573",
            "telephone_number": "973-423-3983",
            "fax_number": "201-485-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 BELMONT AVE",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082573",
            "telephone_number": "973-423-3983",
            "fax_number": "201-485-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGOS",
        "first_name": "GERARD",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04583300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haledon, NJ

Sources for this page

Verify at the official NPI Registry.