Roland Al Achtau, LCSW, LCADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05899800 Issued in NJ

Practice address

121 Rea Avenue
Hawthorne, NJ 07506

Phone

(973) 963-4656

NPI assigned

Apr 16, 2019

Last updated

Jan 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Convictions Recovery

  • Adult Mental Health Clinic/Center
  • Hawthorne, NJ
  • NPI 1992398424
  NPD Authorized official

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1861055808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HARMER TER",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702869",
            "telephone_number": "973-557-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 REA AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "07506",
            "telephone_number": "973-963-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHTAU",
        "first_name": "ROLAND",
        "middle_name": "AL",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00281800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05899800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Center for Foot and Ankle Surgery PA (The Center for Special Surgery of Hawthorne)
• Jonathan M Abenaim, DMD
• Access Pain & Spine
• Aceso Psychotherapy
• Active Motion Physical Therapy
• Adam Rauzman D.D.S.
• Maribel Adamo, MA, LPC
• Advanced Pain and Spine Center LLC
• Advocare , LLC

• Clinical Social Worker in Hawthorne, NJ
• Providers in Hawthorne, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.