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

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