Annette Cecile Provencher, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04823100 Issued in NJ

Practice address

210 Broad St
Red Bank, NJ 07701-2060

Phone

(732) 876-3094

Fax

(732) 615-2359

NPI assigned

May 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Annette Provencher LCSW LLC

  • Clinical Social Worker
  • Middletown, NJ
  • NPI 1225579162
  Medicare reassignment NPD Authorized official
• NJ Behavioral Health Services PC

  • Clinical Psychologist
  • Paramus, NJ
  • NPI 1447289376
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1972715738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CHAPMAN TER",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077481563",
            "telephone_number": "732-615-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012060",
            "telephone_number": "732-876-3094",
            "fax_number": "732-615-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCHER",
        "first_name": "ANNETTE",
        "middle_name": "CECILE",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04823100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precision Eyecare of NJ LLC
• Meredith Price, PTA
• Joanna McGill Primont, M.A. CCC/SLP
• Professional Occupational & Physical Therapy, PLLC
• Jill Propper, LMT
• Providential Medical Center PC
• Psychology Associates
• Theresa Pugliese, PNP
• Erica Pulido, LAC
• Pure Health Chiropractic LLC

• Clinical Social Worker in Red Bank, NJ
• Providers in Red Bank, 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 Nov 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.