Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Laurel Rhona Fastow

Individual provider Clinical Social Worker · NPI 1710740659

Laurel Rhona Fastow is a Clinical Social Worker in South Orange, New Jersey. Qualified in 1981, 45 years ago. Practices with Jespy House, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
45
Licensed in
NJ
In the registry since
2024
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Practice location Address checks out

76 S Orange Ave Ste 214
South Orange, NJ 07079-1923
Phone: (973) 704-4657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 44SC00597000 (NJ)

Record details

NPI number1710740659
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 2, 2024
Last updated in NPPESApril 24, 2024
Certification dateApril 24, 2024
Mailing address76 S Orange Ave Ste 214, South Orange, NJ 07079-1923

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1981 (45 years in practice)
Group practice Jespy House — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in South Orange