Colleen Kjems, LCADC, CCS, NCAC1, I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00090000 Issued in NJ

Practice address

615 Hope Rd Ste 5B5A&4a
Eatontown, NJ 07724-1277

Phone

(732) 858-5432

NPI assigned

Jun 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Colleen Kjems Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1043949514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 FOX ST",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087593612",
            "telephone_number": "848-469-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 5B5A&4A",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-858-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KJEMS",
        "first_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "LCADC, CCS, NCAC1, I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00090000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckjems@integratedcareconcepts.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e mail",
            "address_1": "615 Hope Rd Ste 5B5A&4A",
            "city": "Eatontown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077241277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "KJEMS",
            "prefix": "MS.",
            "credential": "LCADC, CCS, NCAC1, I",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Eatontown, NJ
• Providers in Eatontown, 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 Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.