Individual provider Active NPI

Jessica Michele Perrella, MSW M.ED LCSW

  • Clinical Social Worker
  • Holmdel, NJ
National Provider Identifier
1811479066
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
717 N Beers St Ste 2B
Holmdel, NJ 07733-1525
Phone
(732) 264-2440
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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 Primary

Addresses

Primary practice location

717 N Beers St Ste 2B
Holmdel, NJ 07733-1525

Mailing address

717 N Beers St Ste 2B
Holmdel, NJ 07733-1525
Phone (732) 264-2440

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
I20201013003672 NJ Practitioner - Clinical Social Worker 7719230705 Reassigns benefits to 1 organization
Practice locations: Holmdel, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Scotch Plains, NJ 07076
Phone (908) 456-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Perrella LCSW Inc Clinical CurrentSince Mar 23, 2023 Accepting new patients

Locations

717 N Beers St
Ste 2B
Holmdel, NJ 07733
Phone (732) 264-2440

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, 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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1811479066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 N BEERS ST STE 2B",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331525",
            "telephone_number": "732-264-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N BEERS ST STE 2B",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331525",
            "telephone_number": "732-264-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRELLA",
        "first_name": "JESSICA",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "MSW M.ED LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.