Individual provider Active NPI

Sandra M Powell, LCSW

  • Clinical Social Worker
  • Roselle, NJ
National Provider Identifier
1972703098
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00527800 Issued in NJ
Practice address
221 Chestnut St
Roselle, NJ 07203-1297
Phone
(917) 623-3634
NPI assigned
Jul 18, 2007
Last updated
Oct 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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 44SC00527800 NJ Primary

Addresses

Primary practice location

221 Chestnut St
Roselle, NJ 07203-1297

Mailing address

221 Chestnut St # B02
Roselle, NJ 07203-1297
Phone (917) 623-3634

Other identifiers 1

IdentifierTypeStateIssuer
0161632MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC00527800NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Family Services LLC Clinical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1972703098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 CHESTNUT ST # B02",
            "city": "ROSELLE",
            "state": "NJ",
            "postal_code": "072031297",
            "telephone_number": "917-623-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 CHESTNUT ST",
            "city": "ROSELLE",
            "state": "NJ",
            "postal_code": "072031297",
            "telephone_number": "917-623-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00527800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161632",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.