Individual provider Active NPI

Ila A Keiner, LCSW

  • Clinical Social Worker
  • Galloway, NJ
National Provider Identifier
1811927676
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04607300 Issued in NJ
Practice address
311 S New York Rd
Suite 25
Galloway, NJ 08205-6025
Phone
(609) 748-1820
Fax
(609) 404-3116
NPI assigned
Jul 4, 2006
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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 44SC04607300 NJ Primary

Addresses

Primary practice location

311 S New York Rd
Suite 25
Galloway, NJ 08205-6025

Mailing address

311 S New York Rd
Suite 25
Galloway, NJ 08205-6025
Phone (609) 748-1820

Other identifiers 1

IdentifierTypeStateIssuer
0019887MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04607300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Chazin MD LLC Past Accepting new patients
Ila a. Keiner LLC Clinical Past Accepting new patients

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1811927676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S NEW YORK RD",
            "address_2": "SUITE 25",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082056025",
            "telephone_number": "609-748-1820",
            "fax_number": "609-404-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S NEW YORK RD",
            "address_2": "SUITE 25",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082056025",
            "telephone_number": "609-748-1820",
            "fax_number": "609-404-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEINER",
        "first_name": "ILA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04607300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019887",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.