Individual provider Active NPI

Taji S. Karim-Reisch, LCSW

  • Clinical Social Worker
  • Nutley, NJ
National Provider Identifier
1871196832
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
54 Brookfield Ave
Nutley, NJ 07110-1804
Phone
(973) 216-7022
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Mental Health Counselor 101YM0800X 44SL06205200 NJ

Addresses

Primary practice location

54 Brookfield Ave
Nutley, NJ 07110-1804

Mailing address

54 Brookfield Ave
Nutley, NJ 07110-1804
Phone (973) 216-7022

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Nutley

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20201203000925 NJ Practitioner - Clinical Social Worker 7315358991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

54 Brookfield Ave
Nutley, NJ 07110-1804
Phone (973) 216-7022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06205200NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Matters & Solutions LLC Mental Health CurrentSince Feb 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1871196832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BROOKFIELD AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101804",
            "telephone_number": "973-216-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 BROOKFIELD AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101804",
            "telephone_number": "973-216-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIM-REISCH",
        "first_name": "TAJI",
        "middle_name": "S.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL06205200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Nutley",
            "affiliation": "N",
            "address_1": "18 Aspen Dr",
            "city": "Livingston",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070391432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

Verify at the official NPI Registry.