Active NPI
Carol Ann Conrad, LCSW
- Clinical Social Worker
- Mount Laurel, NJ
National Provider Identifier
1821146937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC00765500
- Practice address
- 104 Peppergrass Dr S
Mount Laurel, NJ 08054-6928 - Phone
- (856) 296-7600
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC00765500 | NJ | Primary |
Addresses
Primary practice location
104 Peppergrass Dr S
Mount Laurel, NJ 08054-6928
Mailing address
104 Peppergrass Dr S
Mount Laurel, NJ 08054-6928
Phone (856) 296-7600
Other practice location 1
1916 Marlton Pike E
Suite 2
Cherry Hill, NJ 08003-2139
Phone (856) 489-1119
Other names 1
- Carol Ann Bandoroff
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC00765500 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- carolconrad@tdh.allscriptsdirect.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646870400000",
"number": "1821146937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 PEPPERGRASS DR S",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080546928",
"telephone_number": "856-296-7600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 PEPPERGRASS DR S",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080546928",
"telephone_number": "856-296-7600"
}
],
"practiceLocations": [
{
"address_1": "1916 Marlton Pike E",
"address_2": "Suite 2",
"address_purpose": "LOCATION",
"city": "Cherry Hill",
"state": "NJ",
"postal_code": "080032139",
"country_code": "US",
"telephone_number": "856-489-1119",
"fax_number": "856-983-1975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONRAD",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC00765500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROL",
"last_name": "BANDOROFF",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Laurel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.