Anna Fudim-Kirshblum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05795800 Issued in NJ

Practice address

71 Woodland Ave
West Orange, NJ 07052-2930

Phone

(862) 250-2423

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jewish Family Service and Childrens Center of Clifton-Passaic, IncGroup PAC ID 3678749223, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jewish Family Service & Childrens Center of Clifton-Passaic, Inc

  • Clinical Social Worker
  • Passaic, NJ
  • NPI 1073885026
  Medicare reassignment Care Compare group NPD
• Anna Kirshblum LLC

  • Clinical Social Worker
  • West Orange, NJ
  • NPI 1376009738
  NPD (past) Authorized official

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1821569013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 WOODLAND AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522930",
            "telephone_number": "973-449-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 WOODLAND AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522930",
            "telephone_number": "862-250-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDIM-KIRSHBLUM",
        "first_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05795800",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Freidl
• Joseph Fretta, MD
• Gary S Friedman, M.D.
• Taylor Friedman
• Deborah S Fruchtman, M.D.
• Christodoulos A Fysentzou, PT
• G&M Therapy Group LLC
• Romina F Gadea
• Carly Galanaugh
• Louis C Galdieri, MD

• Clinical Social Worker in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.