Individual provider Active NPI

Maglenny Alcantara, LSW

  • Mental Health Counselor
  • Somerville, NJ
National Provider Identifier
1790449700
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SL06605900 Issued in NJ
Practice address
285 E Main St
Somerville, NJ 08876-3005
Phone
(201) 966-6174
NPI assigned
Oct 26, 2021
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SL06605900 NJ Primary

Addresses

Primary practice location

285 E Main St
Somerville, NJ 08876-3005

Mailing address

161 Rutgers Rd # a
Piscataway, NJ 08854-3444
Phone (201) 966-6174

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Somerville Direct

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
I20241230001778 NJ Practitioner - Clinical Social Worker 1557898723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vimax LLCGroup PAC ID 7416273644, 21 clinicians

Practice addresses (Care Compare)

6 Cornwall CT
Suite B
East Brunswick, NJ 08816-3347
Phone (732) 955-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06605900NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vimax LLC CurrentSince Dec 6, 2024 Accepting new patients
Vimax LLC CurrentSince Dec 6, 2024 Accepting new patients

Locations

6 Cornwall Ct
Ste B
East Brunswick, NJ 08816
Phone (732) 955-4141

Organizations & group practices 2

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": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1790449700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 RUTGERS RD # A",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088543444",
            "telephone_number": "201-966-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 E MAIN ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088763005",
            "telephone_number": "201-966-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCANTARA",
        "first_name": "MAGLENNY",
        "name_prefix": "Ms.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL06605900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Somerville",
            "affiliation": "N",
            "endpointDescription": "doxy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "285 E Main St",
            "city": "Somerville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088763005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

Verify at the official NPI Registry.