Individual provider Active NPI

Madeline Skalitza, LCSW

  • Clinical Social Worker
  • Lakewood, NJ
National Provider Identifier
1831288455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC04941 Issued in NJ
Practice address
700 Airport Rd
Lakewood, NJ 08701-5907
Phone
(732) 367-4700
Fax
(732) 364-2253
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SC04941 NJ Primary

Addresses

Primary practice location

700 Airport Rd
Lakewood, NJ 08701-5907

Mailing address

700 Airport Rd
P.O. Box 2036
Lakewood, NJ 08701-5907
Phone (732) 367-4700

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
I20070619000211 NJ Practitioner - Clinical Social Worker 1355440298 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC04941NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Behavioral Health Services PC Clinical CurrentSince Feb 18, 2019 Accepting new patients

Locations

140 E Ridgewood Ave
Ste 415
Paramus, NJ 07652
Phone (201) 720-1900

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831288455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 AIRPORT RD",
            "address_2": "P.O. BOX 2036",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015907",
            "telephone_number": "732-367-4700",
            "fax_number": "732-364-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 AIRPORT RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015907",
            "telephone_number": "732-367-4700",
            "fax_number": "732-364-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKALITZA",
        "first_name": "MADELINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC04941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.