Isabel R. De Master, L.C.S.W.

Individual provider Active NPI Mental Health Counselor · Waldwick, NJ

NPI 1881614725 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1881614725
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
44SC00128800 (NJ)
Practice address
71 Franklin Tpke
Floor 2 Suite 4
Waldwick, NJ 07463-1851
Phone
(201) 447-1220
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

71 Franklin Tpke
FL 2 Suite 4
Waldwick, NJ 07465-1800

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040310000690 NJ Practitioner - Clinical Social Worker 2668360561 Practice locations: Waldwick, NJ

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
44SC00128800NJMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SC00128800 NJ Yes

Addresses

Primary practice location

71 Franklin Tpke
Floor 2 Suite 4
Waldwick, NJ 07463-1851

Mailing address

83 Park Ave
Allendale, NJ 07401-1715
Phone (201) 327-2717

Other identifiers

IdentifierTypeStateIssuer
99380OtherUBH
141381OtherVALUE OPTIONS
5643121OtherAETNA
P1536350OtherOXFORD

Other providers in Waldwick, NJ

All providers in Waldwick, NJ · Mental Health Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.