NPIMap

Organization Active NPI

Empowerment Diversity and Inclusion

  • Clinical Social Worker
  • Eatontown, NJ
National Provider Identifier
1831850056
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
EMPOWERMENT DIVERSITY AND INCLUSION
Practice address
615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277
Phone
(732) 389-0697
Fax
(732) 389-0611
NPI assigned
Jan 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
John Larry Thompson, LCSW
Title
Founder
Phone
(732) 389-0697

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277

Mailing address

615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277
Phone (732) 389-0697

Other practice location 1

18 Kings Hwy
Middletown, NJ 07748-2509
Phone (732) 389-0697

Other practice location 2

19 N County Line Rd
Jackson, NJ 08527-1466
Phone (732) 389-0697

Other practice location 3

10 N Willow St
Montclair, NJ 07042-3508
Phone (732) 389-0697

National Provider Directory

National Provider Directory

Locations

615 Hope Rd
Bldg 5B2ND
Eatontown, NJ 07724
Phone (732) 389-0697

19 N County Line Rd
Jackson, NJ 08527
Phone (732) 389-0697

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1831850056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD BLDG 5B2ND",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD BLDG 5B2ND",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NJ",
            "postal_code": "077482509",
            "country_code": "US",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 N County Line Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NJ",
            "postal_code": "085271466",
            "country_code": "US",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 N Willow St",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070423508",
            "country_code": "US",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMPOWERMENT DIVERSITY AND INCLUSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "732-389-0697",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.