NPIMap

Organization Active NPI

Theracorp, LLC

  • Clinical Social Worker
  • East Brunswick, NJ
National Provider Identifier
1790284909
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THERACORP, LLC
Practice address
86 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone
(973) 207-6834
NPI assigned
Feb 3, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Alla Krutyansky, MSW, LSWNPI 1497293096
Title
President/Chief Operating Officer
Phone
(973) 207-6834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NJ Primary

Addresses

Primary practice location

86 Brunswick Woods Dr
East Brunswick, NJ 08816-5601

Mailing address

5 Roxy CT
Farmingdale, NJ 07727-4203
Phone (973) 207-6834

Other practice location 1

79 E Railroad Ave
Jamesburg, NJ 08831-1207
Phone (973) 207-6834

Other names 1

  • TheraCorp Therapeutic Solutions Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220001235 NJ Part B Supplier - Clinic/Group Practice 8426319104 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Brunswick, NJ; Jamesburg, NJ; Howell, NJ; Hoboken, NJ; Farmingdale, NJ; Fairfield, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

84 Brunswick Woods Dr
East Brunswick, NJ 08816
Phone (973) 207-6834

79 E Railroad Ave
Jamesburg, NJ 08831
Phone (973) 207-6834

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1517616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1790284909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ROXY CT",
            "city": "FARMINGDALE",
            "state": "NJ",
            "postal_code": "077274203",
            "telephone_number": "973-207-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 BRUNSWICK WOODS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165601",
            "telephone_number": "973-207-6834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 E Railroad Ave",
            "address_purpose": "LOCATION",
            "city": "Jamesburg",
            "state": "NJ",
            "postal_code": "088311207",
            "country_code": "US",
            "telephone_number": "973-207-6834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERACORP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "KRUTYANSKY",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "973-207-6834",
        "authorized_official_credential": "MSW, LSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TheraCorp Therapeutic Solutions",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.