Gail Leslie Fabrikant, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04302300 Issued in NJ

Practice address

100 Market St
Montvale, NJ 07645-1900

Phone

(201) 207-9711

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gail Leslie Fabrikant-Matsil Former name

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1801574355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARKET ST",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451900",
            "telephone_number": "201-207-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARKET ST",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451900",
            "telephone_number": "201-207-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIKANT",
        "first_name": "GAIL",
        "middle_name": "LESLIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04302300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "FABRIKANT-MATSIL",
            "middle_name": "LESLIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.