Individual provider Active NPI

William Charles Sanderson, LCSW

  • Psychologist
  • New Brunswick, NJ
National Provider Identifier
1871574723
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SC01287 Issued in NJ
Practice address
46 Bartlett St
New Brunswick, NJ 08901-1152
Phone
(908) 759-3417
Fax
(732) 805-9808
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X SC01287 NJ Primary

Addresses

Primary practice location

46 Bartlett St
New Brunswick, NJ 08901-1152

Mailing address

46 Bartlett St
New Brunswick, NJ 08901-1152
Phone (908) 759-3417

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
I20050216000559 NJ Practitioner - Clinical Social Worker 0941252175 Practice locations: Port Murray, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

51 Karrsville Rd
Port Murray, NJ 07865-4118
Phone (908) 759-3417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC01287NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anxiety & Depression Treatment Center LLC Past Accepting new patients

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1871574723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 BARTLETT ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011152",
            "telephone_number": "908-759-3417",
            "fax_number": "732-805-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 BARTLETT ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011152",
            "telephone_number": "908-759-3417",
            "fax_number": "732-805-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "WILLIAM",
        "middle_name": "CHARLES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SC01287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.