Individual provider Active NPI

Julie Dziedzic-Carroll, LCSW

  • Clinical Social Worker
  • New Providence, NJ
National Provider Identifier
1821500679
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04676200 Issued in NJ
Practice address
121 Chanlon Rd
New Providence, NJ 07974-1543
Phone
(908) 367-6148
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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 44SC04676200 NJ Primary

Addresses

Primary practice location

121 Chanlon Rd
New Providence, NJ 07974-1543

Mailing address

121 Chanlon Rd
New Providence, NJ 07974-1543
Phone (908) 367-6148

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

Interoperability endpoints

  • Direct secure messaging: julie.dziedziccarroll.1@2983.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1821500679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CHANLON RD",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741543",
            "telephone_number": "908-367-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CHANLON RD",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741543",
            "telephone_number": "908-367-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEDZIC-CARROLL",
        "first_name": "JULIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04676200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Providence, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.