Kelsey Oakes Bisson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05774700 Issued in NJ

Practice address

666 Godwin Ave Ste 300
Midland Park, NJ 07432-1463

Phone

(201) 444-8110

Fax

(201) 444-8177

NPI assigned

Mar 2, 2017

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Montclair Hospital LLC

  • Adult Mental Health Clinic/Center
  • Montclair, NJ
  • NPI 1386893659
  Medicare reassignment

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1942740477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 GODWIN AVE STE 300",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321463",
            "telephone_number": "201-444-8110",
            "fax_number": "201-444-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 GODWIN AVE STE 300",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321463",
            "telephone_number": "201-444-8110",
            "fax_number": "201-444-8177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070424837",
            "country_code": "US",
            "telephone_number": "973-429-6857",
            "fax_number": "973-429-6032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISSON",
        "first_name": "KELSEY",
        "middle_name": "OAKES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05603300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05774700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Baumann, M.A. CCC-SLP
• Elizabeth Belfiore
• Steven D Belt, M.D.
• Bergen CBT, LLC
• Bergen Smiles Dental Clinic, LLC
• Benjamin Isaac Bittman
• Jessica W Blume, MD
• Christine Rauscher Boi, RDN
• Peter S Boustani, OT
• Nicole Joy Brauch, LAMFT

• Clinical Social Worker in Midland Park, NJ
• Providers in Midland Park, 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 Dec 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.