Individual provider Active NPI

Faye Bodenstein, ACSW

  • Clinical Social Worker
  • Clark, NJ
National Provider Identifier
1841490968
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00753800 Issued in NJ
Practice address
15 Brant Ave
Suite 3
Clark, NJ 07066-1564
Phone
(908) 930-3069
Fax
(908) 889-0688
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 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 44SC00753800 NJ Primary

Addresses

Primary practice location

15 Brant Ave
Suite 3
Clark, NJ 07066-1564

Mailing address

11 Pitching Way
Scotch Plains, NJ 07076-2911
Phone (908) 889-0688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC00753800NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1841490968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PITCHING WAY",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070762911",
            "telephone_number": "908-889-0688",
            "fax_number": "908-889-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BRANT AVE",
            "address_2": "SUITE 3",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661564",
            "telephone_number": "908-930-3069",
            "fax_number": "908-889-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENSTEIN",
        "first_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00753800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.