Individual provider Active NPI

Rachel Max Sicherman, L.C.S.W.

  • Clinical Social Worker
  • Montville, NJ
National Provider Identifier
1902009129
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05763200 Issued in NJ
Practice address
137 Main Rd
Suite 100
Montville, NJ 07045-9231
Phone
(973) 634-5043
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL04690600 NJ
Clinical Social Worker 1041C0700X 44SC05763200 NJ Primary

Addresses

Primary practice location

137 Main Rd
Suite 100
Montville, NJ 07045-9231

Mailing address

137 Main Rd
Suite 100
Montville, NJ 07045-9231
Phone (973) 634-5043

Other names 1

  • Rachel Krupnick Former name

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
I20180410001675 NJ Practitioner - Clinical Social Worker 9537422399 Practice locations: Montville, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

137 Main Rd
Suite 100
Montville, NJ 07045-9231
Phone (973) 634-5043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL04690600NJMDSocial Worker
44SC05763200NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1902009129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MAIN RD",
            "address_2": "SUITE 100",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459231",
            "telephone_number": "973-634-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MAIN RD",
            "address_2": "SUITE 100",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459231",
            "telephone_number": "973-634-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICHERMAN",
        "first_name": "RACHEL",
        "middle_name": "MAX",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL04690600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05763200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "KRUPNICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montville, NJ

Sources for this page

Verify at the official NPI Registry.