Newark Community Street Team, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NEWARK COMMUNITY STREET TEAM, INC.

Doing business as

Newark Community Street Team

Practice address

915 S 16TH St
Newark, NJ 07108-1120

Phone

(973) 351-4529

NPI assigned

Aug 6, 2024

Last updated

Aug 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Angelica M Maury, LSWNPI 1710754387

Title

Trauma Recovery Center Director

Phone

(862) 371-5635

Specialties & licenses 1

Addresses

Other names 1

• Newark Community Street Team Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angelica Michelle Maury

  • Social Worker
  • Paterson, NJ
  • NPI 1710754387
  Authorized official Same address or phone

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1841020708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 S 16TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081120",
            "telephone_number": "973-351-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S 16TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081120",
            "telephone_number": "973-351-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK COMMUNITY STREET TEAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "MAURY",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "TRAUMA RECOVERY CENTER DIRECTOR",
        "authorized_official_telephone_number": "862-371-5635",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newark Community Street Team",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Newark, NJ
• Providers in Newark, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.