Organization Active NPI

Deborah Foulkes LLC

  • Professional Counselor
  • Maplewood, NJ
National Provider Identifier
1033639927
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
DEBORAH FOULKES LLC
Practice address
111 Dunnell Rd Ste 201
Maplewood, NJ 07040-2678
Phone
(973) 330-8123
Fax
(973) 671-4616
NPI assigned
Jun 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. Deborah Foulkes Bert, LPCNPI 1366627713
Title
Founder & Ceo
Phone
(917) 846-9228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Pastoral Counselor 101YP1600X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

111 Dunnell Rd Ste 201
Maplewood, NJ 07040-2678

Mailing address

2999 Sanctuary Dr
Clermont, FL 34714-4749
Phone (917) 846-9228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241223003366 NJ Part B Supplier - Clinic/Group Practice 1254508427 Receives reassigned benefits from 1 practitioner
Practice locations: Maplewood, NJ

National Provider Directory

National Provider Directory

Locations

111 Dunnell Rd
Ste 201
Maplewood, NJ 07040
Phone (973) 330-8123

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1033639927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 SANCTUARY DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347144749",
            "telephone_number": "917-846-9228",
            "fax_number": "973-671-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DUNNELL RD STE 201",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402678",
            "telephone_number": "973-330-8123",
            "fax_number": "973-671-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH FOULKES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "FOULKES BERT",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "FOUNDER & CEO",
        "authorized_official_telephone_number": "917-846-9228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.