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JACQUELINE DURHAM, LLC.
NPI 1295392850
Social Worker - Clinical in Red Bank, NJ

Active since May 20, 2019
214 BROAD ST, RED BANK, NJ 07701(732) 690-2611 Get Directions Write a Review

NPPES record last updated: October 7, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 7, 2019, May 20, 2019 (2 updates tracked since 2019).

About Jacqueline Durham, Llc. NPPES

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

JACQUELINE DURHAM, LLC. (NPI 1295392850) is a healthcare organization registered as a clinical in Red Bank, New Jersey and active in the NPI registry since May 2019. The organization lists Kathleen M. Garcia, Account Manager, as its authorized official.

NPPES Registry Identity

NPI1295392850
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameJACQUELINE DURHAM, LLC.
Location Address214 BROAD STRed Bank, NJ 07701-2026
Mailing Address214 Broad StRed Bank, NJ 07701-2026 · (732) 690-2611
Phone(732) 690-2611
Organization SubpartNo
Authorized OfficialKathleen M. GarciaAccount Manager · (856) 242-3736
Enumeration DateMay 20, 2019
Last NPPES UpdateOctober 7, 20192 updates tracked since enumeration
✔ NPI 1295392850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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.
214 BROAD ST, Red Bank, NJ 07701
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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)

Jacqueline Durham, 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 Jacqueline Durham, LLC., which bills Medicare for the services this clinician delivers.

Clinician (1)

Jacqueline Durham, MSW, LCSW
Clinical Social Worker
NPI 1609235498
214 BROAD ST STE 2
Red Bank, NJ 07701
(732) 690-2611
✔ PECOS✔ Accepts MedicareSame address

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 Jacqueline Durham, LLC.'s NPI number?

The NPI number for Jacqueline Durham, LLC. is 1295392850. It was assigned to this organization in the NPPES registry on May 20, 2019.

Where is Jacqueline Durham, LLC. located?

Jacqueline Durham, LLC. is located at 214 Broad St, Red Bank, NJ 07701. The listed phone number is (732) 690-2611.

What is Jacqueline Durham, LLC.'s specialty?

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

Is Jacqueline Durham, LLC. enrolled in Medicare?

Yes. Jacqueline Durham, LLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jacqueline Durham, LLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Jacqueline Durham, 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 Jacqueline Durham, LLC. was last updated on October 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.