NPIMap

Organization Active NPI

Phoenix Psychotherapy LLC

  • Clinical Social Worker
  • Englishtown, NJ
National Provider Identifier
1851045207
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PHOENIX PSYCHOTHERAPY LLC
Practice address
191 US 9 S
Englishtown, NJ 07726-8233
Phone
(732) 786-4804
Fax
(732) 612-5110
NPI assigned
Feb 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Authorized official

Name
Katie Smaldone, MSW, LCSWNPI 1447726856
Title
Owner/Psychotherapist
Phone
(732) 786-4804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

191 US 9 S
Englishtown, NJ 07726-8233

Mailing address

191 US 9 S
Englishtown, NJ 07726-8233
Phone (732) 786-4804

Other identifiers 2

IdentifierTypeStateIssuer
1447726856OtherINDIVIDUAL NPI
44SC05977000OtherNJLCSW

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address katie@phoenixpsychotherapyllc.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1851045207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 US 9 S",
            "city": "ENGLISHTOWN",
            "state": "NJ",
            "postal_code": "077268233",
            "telephone_number": "732-786-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 US 9 S",
            "city": "ENGLISHTOWN",
            "state": "NJ",
            "postal_code": "077268233",
            "telephone_number": "732-786-4804",
            "fax_number": "732-612-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "SMALDONE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "732-786-4804",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1447726856",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "44SC05977000",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katie@phoenixpsychotherapyllc.com",
            "affiliation": "N",
            "endpointDescription": "HPPA Compliant Email",
            "address_1": "191 US 9 S",
            "city": "Englishtown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077268233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englishtown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.