Individual provider Active NPI

Gloria Wyka, L.C.S.W.

  • Clinical Social Worker
  • Pequannock, NJ
National Provider Identifier
1770857344
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05425300 Issued in NJ
Practice address
7 Industrial Rd Ste 206
Pequannock, NJ 07440-1901
Phone
(201) 709-6548
NPI assigned
Feb 29, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 44SC05425300 NJ Primary

Addresses

Primary practice location

7 Industrial Rd Ste 206
Pequannock, NJ 07440-1901

Mailing address

7 Industrial Rd Ste 206
Pequannock, NJ 07440-1901
Phone (201) 709-6548

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
I20250718000148 NJ Practitioner - Clinical Social Worker 7517473598 Practice locations: Pequannock, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7 Industrial Rd
Suite 206
Pequannock, NJ 07440-1901
Phone (201) 709-6548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770857344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 INDUSTRIAL RD STE 206",
            "city": "PEQUANNOCK",
            "state": "NJ",
            "postal_code": "074401901",
            "telephone_number": "201-709-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDUSTRIAL RD STE 206",
            "city": "PEQUANNOCK",
            "state": "NJ",
            "postal_code": "074401901",
            "telephone_number": "201-709-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYKA",
        "first_name": "GLORIA",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05425300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pequannock, NJ

Sources for this page

Verify at the official NPI Registry.