Gwen Islam, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06470900 Issued in NJ

Practice address

40 Eisenhower Dr
Paramus, NJ 07652-1404

Phone

(201) 870-1943

Fax

(201) 291-0888

NPI assigned

Apr 13, 2021

Last updated

Apr 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

The Bridge of Central Massachusetts IncGroup PAC ID 1658694393, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Bridge of Central Massachusetts, Inc.

  dba Open Sky Community Services, Inc

  • Community/Behavioral Health Agency
  • Worcester, MA
  • NPI 1740657527
  Medicare reassignment Care Compare group NPD
• The Bridge of Central Massachusetts, Inc

  • Foster Care Agency
  • Worcester, MA
  • NPI 1053746255
  NPD
• American Day CD Centers, L.L.C.

  dba High Focus Centers

  • Clinic/Center
  • Paramus, NJ
  • NPI 1184754160
  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1851971766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 DEERFIELD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016024348",
            "telephone_number": "978-505-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EISENHOWER DR",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521404",
            "telephone_number": "201-870-1943",
            "fax_number": "201-291-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "GWEN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06470900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intervention Strategies N.J.
• V. Christopher Inzerillo, M.D.
• Fatima Iqbal, MD
• Michele Isaacs, M.D.
• Katherine Julie Isidor, DPT
• Deborah Issa, NP-C
• Rouba Isshak, MD
• Emily Iuppa
• Robin Juliette Iversen, MD
• Ivx Health of New Jersey, P.C. (IVX Health)

• Social Worker in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.