Individual provider Active NPI

Michele A Walsh, LCSW

  • Clinical Social Worker
  • Newton, NJ
National Provider Identifier
1972335420
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06370600 Issued in NJ
Practice address
83 Spring St Ste 303
Newton, NJ 07860-2080
Phone
(973) 840-1850
Fax
(973) 383-0256
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06370600 NJ Primary

Addresses

Primary practice location

83 Spring St Ste 303
Newton, NJ 07860-2080

Mailing address

83 Spring St Ste 303
Newton, NJ 07860-2080
Phone (973) 289-9496

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
I20250109003387 NJ Practitioner - Clinical Social Worker 5294263885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Association of Essex and Morris, Inc.Group PAC ID 5597654293, 14 clinicians

Practice addresses (Care Compare)

33 S Fullerton Ave
Montclair, NJ 07042-3358
Phone (973) 509-9777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06370600NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Association of Essex and Morris, Inc. CurrentSince Dec 7, 2024 Accepting new patients

Locations

33 S Fullerton Ave
Montclair, NJ 07042
Phone (973) 509-9777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1972335420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SPRING ST STE 303",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602080",
            "telephone_number": "973-289-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SPRING ST STE 303",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602080",
            "telephone_number": "973-840-1850",
            "fax_number": "973-383-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MICHELE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06370600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, NJ

Sources for this page

Verify at the official NPI Registry.