ANNETTE PROVENCHER LCSW LLC
NPI 1225579162
Social Worker - Clinical in Middletown, NJ

Q: What is Annette Provencher Lcsw LLC's NPI number?

The NPI number for Annette Provencher Lcsw LLC is 1225579162. It was assigned to this organization in the NPPES registry on March 11, 2017.

Q: What is Annette Provencher Lcsw LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since March 11, 2017

24 CHAPMAN TER, MIDDLETOWN, NJ 07748(732) 876-3094 Get Directions Write a Review

NPPES record last updated: March 11, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Annette Provencher Lcsw Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANNETTE PROVENCHER LCSW LLC (NPI 1225579162) is a healthcare organization registered as a clinical in Middletown, New Jersey and active in the NPI registry since March 2017. The organization lists Annette Provencher, Owner, as its authorized official.

NPPES Registry Identity

NPI1225579162

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameANNETTE PROVENCHER LCSW LLC

Location Address24 CHAPMAN TERMiddletown, NJ 07748-1563

Mailing Address39 Avenue At The Cmn, Suite 106Shrewsbury, NJ 07702-4807 · (732) 876-3094

Phone(732) 876-3094

Organization SubpartNo

Authorized OfficialAnnette ProvencherOwner · (732) 876-3094

Enumeration DateMarch 11, 2017

✔ NPI 1225579162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NJ · 44SC04823100

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

24 CHAPMAN TER, Middletown, NJ 07748

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Annette Provencher Lcsw Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Annette Provencher Lcsw LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Annette Provencher, MSW LCSW

Clinical Social Worker

NPI 1972715738

210 BROAD ST
Red Bank, NJ 07701

(732) 876-3094

✔ PECOS✔ Accepts Medicare5.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Annette Provencher Lcsw LLC's NPI number?

The NPI number for Annette Provencher Lcsw LLC is 1225579162. It was assigned to this organization in the NPPES registry on March 11, 2017.

Where is Annette Provencher Lcsw LLC located?

Annette Provencher Lcsw LLC is located at 24 Chapman Ter, Middletown, NJ 07748. The listed phone number is (732) 876-3094.

What is Annette Provencher Lcsw LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Annette Provencher Lcsw LLC enrolled in Medicare?

Yes. Annette Provencher Lcsw LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Annette Provencher Lcsw LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Annette Provencher Lcsw LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Annette Provencher Lcsw LLC was last updated on March 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.