Individual provider Active NPI

Laura K Palm, LCSW

  • Clinical Social Worker
  • Hazlet, NJ
National Provider Identifier
1982752663
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05225800 Issued in NJ
Practice address
1 Bethany Rd Building 5 Ste 69
Hazlet, NJ 07730-1668
Phone
(732) 344-0736
NPI assigned
Jan 8, 2007
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 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 44SC05225800 NJ Primary

Addresses

Primary practice location

1 Bethany Rd Building 5 Ste 69
Hazlet, NJ 07730-1668

Mailing address

1 Bethany Rd Building 5 Ste 69
Hazlet, NJ 07730-1668
Phone (732) 344-0736

Other practice location 1

1088 State Route 34
Matawan, NJ 07747-1948
Phone (732) 290-1700

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
I20070124000194 NJ Practitioner - Clinical Social Worker 4284635905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Bethany Rd
Suite 69
Hazlet, NJ 07730-1668
Phone (732) 344-0736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05225800NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Laura K Palm LCSW Clinical CurrentSince Feb 25, 2020 Accepting new patients
Premier Care LLC Dba Elder Life Home Care LLC Past Accepting new patients
Elder Life Management LLC Clinical PastSince Dec 15, 2013 Accepting new patients

Locations

1 Bethany Rd
Ste 69
Hazlet, NJ 07730
Phone (732) 344-0736

Organizations & group practices 3

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1982752663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BETHANY RD BUILDING 5 STE 69",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301668",
            "telephone_number": "732-344-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BETHANY RD BUILDING 5 STE 69",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301668",
            "telephone_number": "732-344-0736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1088 State Route 34",
            "address_purpose": "LOCATION",
            "city": "Matawan",
            "state": "NJ",
            "postal_code": "077471948",
            "country_code": "US",
            "telephone_number": "732-290-1700",
            "fax_number": "732-290-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALM",
        "first_name": "LAURA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05225800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

Verify at the official NPI Registry.