Individual provider Active NPI

Loverton Fidel, M.A., M.S., M.B.A.

  • Counselor
  • East Brunswick, NJ
National Provider Identifier
1063877686
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
37PC00596700 Issued in NJ
Practice address
6 Cornwall CT Ste B
East Brunswick, NJ 08816-3347
Phone
(732) 955-4141
NPI assigned
Dec 24, 2015
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 37PC00596700 NJ Primary

Addresses

Primary practice location

6 Cornwall CT Ste B
East Brunswick, NJ 08816-3347

Mailing address

1430 Route 27
North Brunswick, NJ 08902-1538
Phone (732) 247-6263

Other practice location 1

169 Main St Ste 2
Matawan, NJ 07747-4105
Phone (732) 247-6263

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
I20251222002614 NJ Practitioner - Mental Health Counselor 8921593401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vimax LLCGroup PAC ID 7416273644, 21 clinicians

Practice addresses (Care Compare)

6 Cornwall Court
Suite B
East Brunswick, NJ 08816-3347

6 Cornwall CT
Suite B
East Brunswick, NJ 08816-3347
Phone (732) 955-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Business Administration, Master of Science

State licenses

LicenseStateTypeSpecialty
37AC00245600NJMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vimax LLC CurrentSince Sep 26, 2025 Accepting new patients
Vimax LLC CurrentSince Sep 26, 2025 Accepting new patients

Locations

6 Cornwall Ct
Ste B
East Brunswick, NJ 08816
Phone (732) 955-4141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1450915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1063877686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 ROUTE 27",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021538",
            "telephone_number": "732-247-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CORNWALL CT STE B",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163347",
            "telephone_number": "732-955-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Main St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Matawan",
            "state": "NJ",
            "postal_code": "077474105",
            "country_code": "US",
            "telephone_number": "732-247-6263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIDEL",
        "first_name": "LOVERTON",
        "name_prefix": "Prof.",
        "credential": "M.A., M.S., M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-24",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37PC00596700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.