Active NPI
James W Fay IV, LPC
- Professional Counselor
- Bridgewater, NJ
National Provider Identifier
1003040312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00423800
- Practice address
- 1065 Rte 22
Suite 3 D
Bridgewater, NJ 08807-2949 - Phone
- (908) 231-0511
- Fax
- (908) 231-1115
- NPI assigned
- May 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 37PC00423800 | NJ | Primary |
Addresses
Primary practice location
1065 Rte 22
Suite 3 D
Bridgewater, NJ 08807-2949
Mailing address
273 Carlton Ave
Washington, NJ 07882-1213
Phone (908) 596-0095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00423800 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genpsych, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Bridgewater, NJ
- NPI 1548447881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1003040312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 CARLTON AVE",
"city": "WASHINGTON",
"state": "NJ",
"postal_code": "078821213",
"telephone_number": "908-596-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1065 RTE 22",
"address_2": "SUITE 3 D",
"city": "BRIDGEWATER",
"state": "NJ",
"postal_code": "088072949",
"telephone_number": "908-231-0511",
"fax_number": "908-231-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAY",
"first_name": "JAMES",
"middle_name": "W",
"name_suffix": "IV",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-14",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00423800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgewater, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.