Individual provider Active NPI

Joseph Chang, LCSW

  • Clinical Social Worker
  • Wayne, NJ
National Provider Identifier
1770943128
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC0618900 Issued in NJ
Practice address
1125A Valley Rd
Wayne, NJ 07470-2338
Phone
(646) 270-6136
NPI assigned
Feb 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 088968 NY
Clinical Social Worker 1041C0700X 44SC0618900 NJ Primary

Addresses

Primary practice location

1125A Valley Rd
Wayne, NJ 07470-2338

Mailing address

1125A Valley Rd
Wayne, NJ 07470-2338
Phone (646) 270-6136

Other names 1

  • Mr. Jo Sep Chang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200605000252 NY Practitioner - Clinical Social Worker 8628499332 Reassigns benefits to 2 organizations
I20220825000188 NJ Practitioner - Clinical Social Worker 8628499332 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC0618900NJMDClinical Social Worker
088968NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.a. Social Worker CurrentSince May 13, 2022 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Dec 27, 2024 Accepting new patients
Valera Medical, P.C. Social Worker CurrentSince Feb 1, 2022 Accepting new patients
Grow Healthcare Group of New Jersey PC Clinical CurrentSince Dec 27, 2024 Accepting new patients
Korean Community Services of Metropolitan New York, Inc. Past Accepting new patients

Locations

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

134 N 4th St
Brooklyn, NY 11249

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

Organizations & group practices 5

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": "1456531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1770943128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125A VALLEY RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702338",
            "telephone_number": "646-270-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125A VALLEY RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702338",
            "telephone_number": "646-270-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-27",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088968",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC0618900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JO",
            "last_name": "CHANG",
            "middle_name": "SEP",
            "prefix": "MR.",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.