Individual provider Active NPI

Michael C. Friedman, MSW, PH.D.

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1821213729
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00098600 Issued in NJ
Practice address
175 Cedar LN
Ste 7
Teaneck, NJ 07666-4315
Phone
(201) 220-5336
Fax
(973) 403-8657
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00098600 NJ Primary
Clinical Social Worker 1041C0700X R013380-1 NY

Addresses

Primary practice location

175 Cedar LN
Ste 7
Teaneck, NJ 07666-4315

Mailing address

175 Cedar LN
Suite 2
Teaneck, NJ 07666-4315
Phone (201) 220-5336

Other identifiers 2

IdentifierTypeStateIssuer
223607770OtherNJFEDERAL TAX ID
223607770OtherNYFEDERAL TAX ID

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
I20050427000100 NJ Practitioner - Clinical Social Worker 0446299762 Practice locations: Sparta, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Sparta, NJ 07871
Phone (201) 220-5336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
44SC00098600NJMDClinical Social Worker
R013380-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1821213729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "SUITE 2",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-220-5336",
            "fax_number": "973-403-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CEDAR LN",
            "address_2": "STE 7",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664315",
            "telephone_number": "201-220-5336",
            "fax_number": "973-403-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "MICHAEL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00098600",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R013380-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "223607770",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "223607770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.