Individual provider Active NPI

Carlene Graham, LCSW

  • Clinical Social Worker
  • Galloway, NJ
National Provider Identifier
1821680224
Registry record updated Feb 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05918700 Issued in NJ
Practice address
755 E Cooper Ferry CT
Galloway, NJ 08205-3108
Phone
(609) 377-0063
NPI assigned
Feb 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2021

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 44SC05918700 NJ Primary

Addresses

Primary practice location

755 E Cooper Ferry CT
Galloway, NJ 08205-3108

Mailing address

755 E Cooper Ferry CT
Galloway, NJ 08205-3108
Phone (609) 377-0063

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
I20210430000258 NJ Practitioner - Clinical Social Worker 9638588817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supportive Care Psychology of NJ PCGroup PAC ID 6002162252, 23 clinicians

Practice addresses (Care Compare)

18 Butler Blvd
Bayville, NJ 08721-3002
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
96.24 of 100Reported as group
Quality
81.01
Improvement activities
40
Cost
88.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05918700NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care Psychology of NJ PC CurrentSince Apr 15, 2021 Accepting new patients
Creative Compassion Counseling LLC CurrentSince Sep 21, 2025 Accepting new patients

Locations

18 Butler Blvd
Bayville, NJ 08721
Phone (732) 237-2220

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

560 Berkeley Ave
Orange, NJ 07050
Phone (973) 672-6500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612656000000",
    "number": "1821680224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 E COOPER FERRY CT",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082053108",
            "telephone_number": "609-377-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 E COOPER FERRY CT",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082053108",
            "telephone_number": "609-377-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CARLENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-07",
        "last_updated": "2021-02-07",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05918700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.