Individual provider Active NPI

Jesse Wayland Adams II, LCSW

  • Clinical Social Worker
  • Asbury Park, NJ
National Provider Identifier
1942711130
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05967300 Issued in NJ
Practice address
418 Bond St
Asbury Park, NJ 07712-6908
Phone
(323) 999-2651
NPI assigned
Oct 16, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 37LC00343300 NJ
Clinical Social Worker 1041C0700X 44SC05967300 NJ Primary

Addresses

Primary practice location

418 Bond St
Asbury Park, NJ 07712-6908

Mailing address

PO Box 1294
Asbury Park, NJ 07712-1294
Phone (323) 999-2651

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
I20220331000015 NJ Practitioner - Clinical Social Worker 6103212121 Reassigns benefits to 1 organization
Practice locations: Asbury Park, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Jersey Health and Wellness LLCGroup PAC ID 3375846637, 16 clinicians

Practice addresses (Care Compare)

35 S Spruce St
Ramsey, NJ 07446-2549
Phone (201) 819-8545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00343300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
College Recovery LLC PastSince Oct 30, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1942711130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1294",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077121294",
            "telephone_number": "323-999-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BOND ST",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077126908",
            "telephone_number": "323-999-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JESSE",
        "middle_name": "WAYLAND",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-16",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "37LC00343300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05967300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asbury Park, NJ

Sources for this page

Verify at the official NPI Registry.