Active NPI
Serena Menefee
- Massage Therapist
- Montclair, NJ
National Provider Identifier
1053048876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 18KT00642800
- Practice address
- Well in Montclair
105 CR-623, Unit 17
Montclair, NJ 07042 - Phone
- (917) 587-0407
- NPI assigned
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 18KT00642800 | NJ | Primary |
Addresses
Primary practice location
Well in Montclair
105 CR-623, Unit 17
Montclair, NJ 07042
Mailing address
PO Box 396
Montclair, NJ 07042-0396
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 |
|---|---|---|---|
| 18KT00642800 | NJ | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1053048876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 396",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070420396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WELL IN MONTCLAIR",
"address_2": "105 CR-623, UNIT 17",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "07042",
"telephone_number": "917-587-0407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENEFEE",
"first_name": "SERENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2022-08-02",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NJ",
"license": "18KT00642800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
- Lani Mendelson, M.D.
- John F Mendes, M.D.
- Robertha Mendez, MD
- Mending Our Minds, Inc
- Mending Wings to Soar
- Mental Health Assn of Essex and Morris
- Mental Health Association of Essex and Morris
- Mental Health Association of Essex and Morris
- Mental Health Association of Essex and Morris, Inc.
- Mental Wellness Montclair, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.