Individual provider Active NPI

Rosemarie Proven-Fahy, LCSW

  • Clinical Social Worker
  • Denville, NJ
National Provider Identifier
1891304622
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05839700 Issued in NJ
Practice address
3175 RT. 10 Building C
Suite 700
Denville, NJ 07834
Phone
(862) 200-7218
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 44SC05839700 NJ Primary

Addresses

Primary practice location

3175 RT. 10 Building C
Suite 700
Denville, NJ 07834

Mailing address

47 Ozone Ave
Cedar Grove, NJ 07009-2130
Phone (973) 768-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC05839700NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1891304622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 OZONE AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070092130",
            "telephone_number": "973-768-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 RT. 10 BUILDING C",
            "address_2": "SUITE 700",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "07834",
            "telephone_number": "862-200-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVEN-FAHY",
        "first_name": "ROSEMARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05839700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.