Jennifer A Flatley, LCSW

Individual provider Active NPI Clinical Social Worker · Wall, NJ

NPI 1982134656 · NPPES record last updated Sep 9, 2019

Key facts

NPI
1982134656
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05821400 (NJ)
Practice address
1540 Rte 138
Wall, NJ 07719-3763
Phone
(732) 261-0513
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

55 Anita Dr
Jackson, NJ 08527-4902

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20191031001218 NJ Practitioner - Clinical Social Worker 7911239595

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
44SL0600650NJMDSocial Worker
44SC05821400NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL0600650 NJ
Clinical Social Worker 1041C0700X 44SC05821400 NJ Yes

Addresses

Primary practice location

1540 Rte 138
Wall, NJ 07719-3763

Mailing address

55 Anita Dr
Jackson, NJ 08527-4902
Phone (732) 261-0513

Other providers in Wall, NJ

All providers in Wall, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.