Active NPI
Xuan T Tran-Walsh, LCSW
- Clinical Social Worker
- Rutherford, NJ
National Provider Identifier
1922630466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 079447
- Practice address
- 46 Daniel Ave
Rutherford, NJ 07070-2705 - Phone
- (646) 470-1891
- NPI assigned
- Feb 11, 2020
- Last updated
- Jan 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 079447 | NY | Primary |
Addresses
Primary practice location
46 Daniel Ave
Rutherford, NJ 07070-2705
Mailing address
46 Daniel Ave
Rutherford, NJ 07070-2705
Phone (646) 470-1891
Other practice location 1
112 W 34th St Fl 17
New York, NY 10120-0001
Phone (646) 470-1891
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
| License | State | Type | Specialty |
|---|---|---|---|
| 079447 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Harbor Psychotherapy LCSW, PLLC | Clinical | Current | Accepting new patients |
Locations
112 W 34th St
Fl 17
New York, NY 10120
Phone (646) 470-1891
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- New York, NY
- NPI 1316579238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1922630466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 DANIEL AVE",
"city": "RUTHERFORD",
"state": "NJ",
"postal_code": "070702705",
"telephone_number": "646-470-1891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 DANIEL AVE",
"city": "RUTHERFORD",
"state": "NJ",
"postal_code": "070702705",
"telephone_number": "646-470-1891"
}
],
"practiceLocations": [
{
"address_1": "112 W 34th St Fl 17",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "101200001",
"country_code": "US",
"telephone_number": "646-470-1891",
"fax_number": "718-744-9755",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRAN-WALSH",
"first_name": "XUAN",
"middle_name": "T",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-11",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "079447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rutherford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.