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81 Crooked Stick Rd Jackson NJ 08527-4032 | |
| (848) 218-0790 | |
| (732) 358-0829 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 81 Crooked Stick Rd, Jackson, New Jersey |
| Authorized Official Name and Position | David Gold (OWNER) |
| Authorized Official Contact | 6099166402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
81 Crooked Stick Rd Jackson NJ 08527-4032 Ph: (609) 916-6400 | 81 Crooked Stick Rd Jackson NJ 08527-4032 Ph: (848) 218-0790 |
| NPI Number | 1477070761 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 3072876994 |
|---|---|
| Medicare Enrollment ID | O20180406000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477070761 | NPI | - | NPPES |
| 44SC05675500 | Other | NJ | LICENSED CLINICAL SOCIAL WORKER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05675500 (New Jersey) | Primary |
| Provider Name | Betty Ann Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104053719 PECOS PAC ID: 3779530191 Enrollment ID: I20050407000003 |
| Provider Name | Dennis F Sharkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568506871 PECOS PAC ID: 5193765592 Enrollment ID: I20050505000041 |
| Provider Name | Roberta Gold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245515113 PECOS PAC ID: 4688837404 Enrollment ID: I20120515000294 |
| Provider Name | Christopher Nackos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285836072 PECOS PAC ID: 8628216058 Enrollment ID: I20130524000359 |
| Provider Name | Judith Schwartzhoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023175445 PECOS PAC ID: 2769586098 Enrollment ID: I20140226001127 |
| Provider Name | Debra Ford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609351915 PECOS PAC ID: 0042563488 Enrollment ID: I20181031003062 |
| Provider Name | Janine J Fabrizio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295158343 PECOS PAC ID: 3577805522 Enrollment ID: I20190424000014 |
| Provider Name | Barbara Edelhauser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346756251 PECOS PAC ID: 6002158920 Enrollment ID: I20190425000206 |
| Provider Name | Joanne Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679051007 PECOS PAC ID: 3971923699 Enrollment ID: I20201019003310 |
| Provider Name | Stacey Spina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417510579 PECOS PAC ID: 8224446968 Enrollment ID: I20210420000117 |
| Provider Name | Chava Ganz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689143117 PECOS PAC ID: 2466842828 Enrollment ID: I20211130000558 |
| Provider Name | Krystin Mutchler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629512207 PECOS PAC ID: 3173902111 Enrollment ID: I20220621002842 |
| Provider Name | Diane Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154748333 PECOS PAC ID: 2769866227 Enrollment ID: I20220901000061 |
| Provider Name | Shawn Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770120594 PECOS PAC ID: 4284018433 Enrollment ID: I20220907001795 |
| Provider Name | Amanda Araujo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548824840 PECOS PAC ID: 5294179313 Enrollment ID: I20240216002170 |
| Provider Name | Keryn Shane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053736769 PECOS PAC ID: 0244621928 Enrollment ID: I20240416001469 |
| Provider Name | Judith Defrancesco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699818690 PECOS PAC ID: 0446690564 Enrollment ID: I20240506003344 |
| Provider Name | Nancy A Abramson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417163148 PECOS PAC ID: 8921134701 Enrollment ID: I20240607000463 |
| Provider Name | Leisha Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063576676 PECOS PAC ID: 9739530791 Enrollment ID: I20240626002682 |
Therapedsnj Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Linda Dr, Jackson, NJ 08527 Phone: 845-642-4266 | |
Alternatives Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Pamela Ct, Jackson, NJ 08527 Phone: 732-928-1026 Fax: 908-685-2660 | |
Sonrise Youth Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Oxford Rd, Jackson, NJ 08527 Phone: 732-814-0764 | |
Ymca Of Greater Monmouth County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Manhattan St, Jackson, NJ 08527 Phone: 732-290-9040 Fax: 732-566-0433 | |
Living Well 4 Life Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 405 Daffodil Dr, Jackson, NJ 08527 Phone: 732-966-5809 | |
Counseling And Psychotherapy For Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Nicole Ct, Jackson, NJ 08527 Phone: 732-664-0772 Fax: 732-928-6290 | |
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