Leroy Stanford Jr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00215600 Issued in NJ

Practice address

2600 Mount Ephraim Ave
Suite 405
Camden, NJ 08104-3236

Phone

(856) 963-7323

Fax

(856) 963-7324

NPI assigned

May 11, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stanford CTC Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Blackwood, NJ
  • NPI 1699247635
  NPD Authorized official
• Women of Hope Resource Center, Inc

  • Community/Behavioral Health Agency
  • Atco, NJ
  • NPI 1740456656
  NPD
• Way of the Spirit Counseling Services Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Camden, NJ
  • NPI 1518335249
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1013395052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MOUNT EPHRAIM AVE",
            "address_2": "SUITE 405",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081043236",
            "telephone_number": "856-963-7323",
            "fax_number": "856-963-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MOUNT EPHRAIM AVE",
            "address_2": "SUITE 405",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081043236",
            "telephone_number": "856-963-7323",
            "fax_number": "856-963-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "LEROY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00215600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinay Kumar Srinivasan, M.D.
• Megan Marie Staerk, APN
• Ernest Albert Stafford Jr., MSW
• Jessica Stage
• Gary E Stahl, MD
• Luke Thomas Stanisce, MD
• Anne Marie Stanley, NP
• Stars Adult Medical Day Care Center
• Sarah Staskiewicz, DO
• State Street Pharmacy

• Addiction (Substance Use Disorder) Counselor in Camden, NJ
• Providers in Camden, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.