Individual provider Active NPI

Sarah Glisky, LCSW

  • Clinical Social Worker
  • Hackensack, NJ
National Provider Identifier
1770822488
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05342100 Issued in NJ
Practice address
331 Summit Ave
Hackensack, NJ 07601-1429
Phone
(201) 488-0408
Fax
(201) 488-0411
NPI assigned
Feb 1, 2013
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072314-1 NY
Clinical Social Worker 1041C0700X 44SC05342100 NJ Primary

Addresses

Primary practice location

331 Summit Ave
Hackensack, NJ 07601-1429

Mailing address

331 Summit Ave
Hackensack, NJ 07601-1429
Phone (201) 488-0408

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
I20151103001542 NJ Practitioner - Clinical Social Worker 6204154875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHG Services, LLCGroup PAC ID 4880968445, 3 clinicians

Practice addresses (Care Compare)

331 Summit Ave
Hackensack, NJ 07601-1429
Phone (201) 488-0408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05342100NJMDClinical Social Worker
072314-1NYMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1770822488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011429",
            "telephone_number": "201-488-0408",
            "fax_number": "201-488-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011429",
            "telephone_number": "201-488-0408",
            "fax_number": "201-488-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLISKY",
        "first_name": "SARAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072314-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05342100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.