Individual provider Active NPI

Kathy Christine Gvardijan, LPC

  • Professional Counselor
  • Parsippany, NJ
National Provider Identifier
1043053242
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC01038300 Issued in NJ
Practice address
22 Hill Rd
Parsippany, NJ 07054-1078
Phone
(973) 335-9909
Fax
(973) 335-9910
NPI assigned
Jun 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC01038300 NJ Primary

Addresses

Primary practice location

22 Hill Rd
Parsippany, NJ 07054-1078

Mailing address

22 Hill Rd
Parsippany, NJ 07054-1078
Phone (973) 335-9909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260115000399 NJ Practitioner - Mental Health Counselor 4789160193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Liberty Univ College of Osteopathic Medicine, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11166 Fairfax Blvd
Suite 500
Fairfax, VA 22030-5017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC01038300NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Onyx Medical LLC CurrentSince Dec 8, 2025 Accepting new patients
Immediate Care Psychiatric Center Past Accepting new patients

Locations

109 W Main St
Denville, NJ 07834
Phone (973) 954-9401

11166 Fairfax Blvd
Ste 500
Fairfax, VA 22030
Phone (703) 403-2750

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1043053242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 HILL RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541078",
            "telephone_number": "973-335-9909",
            "fax_number": "973-335-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HILL RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541078",
            "telephone_number": "973-335-9909",
            "fax_number": "973-335-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GVARDIJAN",
        "first_name": "KATHY",
        "middle_name": "CHRISTINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC01038300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

Verify at the official NPI Registry.