Ryan Gervasi, LCSW, RYT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06054300 Issued in NJ

Practice address

615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277

Phone

(732) 389-0697

NPI assigned

Jan 25, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• CCC Counseling Inc

  • Community/Behavioral Health Agency
  • Lakewood, NJ
  • NPI 1366848582

  Clinical

  Medicare reassignment NPD
• Empowerment Diversity and Inclusion

  • Clinical Social Worker
  • Eatontown, NJ
  • NPI 1831850056
  NPD

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1982310744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 1/2 ELBERON AVE",
            "city": "ALLENHURST",
            "state": "NJ",
            "postal_code": "077111015",
            "telephone_number": "201-772-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD BLDG 5B2ND",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERVASI",
        "first_name": "RYAN",
        "credential": "LCSW, RYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06054300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan Rose Gavan, PA-C
• Heather D Gebhardt, LPC
• Jules M Geltzeiler, MD
• Nikita George, A.A.S., B.SC.
• Steven George
• Amira S Ghaly, PMHNP
• Mohamed Gharib
• Gagandeep Gill, D.C.
• Christopher Charles Gillis, MD
• Laurie Goldman

• Clinical Social Worker in Eatontown, NJ
• Providers in Eatontown, 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 Jan 25, 2023; 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.