Papa Ganache Project, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PAPA GANACHE PROJECT, LLC

Practice address

106 Main St
Matawan, NJ 07747-2656

Phone

(732) 217-1750

Fax

(732) 217-1749

NPI assigned

Feb 13, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Dale Siroti, LCSW

Title

Principal

Phone

(732) 770-0428

Specialties & licenses 5

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lindsay Nelson, MSW, LCSW

  • Clinical Social Worker
  • Matawan, NJ
  • NPI 1316498801
  NPD (past)

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1932523883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472656",
            "telephone_number": "732-217-1750",
            "fax_number": "732-217-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472656",
            "telephone_number": "732-217-1750",
            "fax_number": "732-217-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAPA GANACHE PROJECT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "SIROTI",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "732-770-0428",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252069",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Matawan, NJ
• Providers in Matawan, 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 Feb 13, 2014; 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.