Individual provider Active NPI

Elizabeth Sidlow, LCSW

  • Clinical Social Worker
  • Red Bank, NJ
National Provider Identifier
1770948200
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06020100 Issued in NJ
Practice address
145 Maple Ave
Red Bank, NJ 07701-1717
Phone
(732) 747-9660
Fax
(732) 747-7590
NPI assigned
Dec 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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 44SC06020100 NJ Primary

Addresses

Primary practice location

145 Maple Ave
Red Bank, NJ 07701-1717

Mailing address

5 Maxwell Rd
Eatontown, NJ 07724-3433
Phone (732) 757-5100

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
I20260604001060 NJ Practitioner - Clinical Social Worker 8224509898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

281 State Route 34
Suite 202
Colts Neck, NJ 07722-2439

331 Newman Springs-Rd
One River Center Building 3 Suite 320
Red Bank, NJ 07701-5666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06020100NJMDClinical 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1770948200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MAXWELL RD",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243433",
            "telephone_number": "732-757-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011717",
            "telephone_number": "732-747-9660",
            "fax_number": "732-747-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDLOW",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06020100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.