Jacklyn Coburger, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

432 Baldwin St
Piscataway, NJ 08854-2335

Phone

(732) 586-9550

NPI assigned

Sep 12, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hamilton Behavioral MD PAGroup PAC ID 8426294216, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Hamilton Behavioral MD PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Paramus, NJ
  • NPI 1548500408
  Medicare reassignment Care Compare group NPD
• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098
  Medicare reassignment NPD
• Optimistic Counseling LLC

  • Clinical Social Worker
  • Piscataway, NJ
  • NPI 1346084159
  NPD Authorized official
• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  NPD (past)

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1932500683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 BALDWIN ST",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088542335",
            "telephone_number": "732-586-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 BALDWIN ST",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088542335",
            "telephone_number": "732-586-9550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N Bridge St",
            "address_purpose": "LOCATION",
            "city": "Bridgewater",
            "state": "NJ",
            "postal_code": "088072135",
            "country_code": "US",
            "telephone_number": "908-725-2800 x3018",
            "fax_number": "908-704-1790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBURGER",
        "first_name": "JACKLYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023701",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7797403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason L Clay, BA
• Peter L Clemente, DMD
• Zakia Clements
• Nafeesahn Muslima Clinton, LMSW
• Jerome Coakieanos, LCSW
• Ermes Cogliani, M.D.
• Andrew Nathan Cohen, D.O.
• William K Coimin, COUNSELOR
• Dana Colburn-Gallo, MS, LPC
• Antoinette Cole

• Clinical Social Worker in Piscataway, NJ
• Providers in Piscataway, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.