NPIMap

Organization Active NPI

Theracorp, LLC

  • Clinical Social Worker
  • Jamesburg, NJ
National Provider Identifier
1063947828
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1041X0700X Issued in NJ
Legal business name
THERACORP, LLC
Practice address
79 E Railroad Ave
Jamesburg, NJ 08831-1207
Phone
(732) 561-8555
NPI assigned
Apr 28, 2017
Last updated
Nov 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Authorized official

Name
Mrs. Alla Krutyansky, MSW, LCSWNPI 1497293096
Title
President
Phone
(973) 207-6834

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 9

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 101Y00000X NJ
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 101YA0400X NJ
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 104200000X NJ
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 101YM0800X NJ
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 103T00000X NJ
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X 103TP0016X NJ
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X NJ
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 1041X0700X NJ Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 106H00000X NJ

Addresses

Primary practice location

79 E Railroad Ave
Jamesburg, NJ 08831-1207

Mailing address

79 E Railroad Ave
Jamesburg, NJ 08831-1207
Phone (732) 561-8555

Other practice location 1

271 Route 46 W Ste G201
Fairfield, NJ 07004-2475
Phone (732) 561-8555

Other names 1

  • TheraCorp Therapeutic Solutions Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220001235 NJ Part B Supplier - Clinic/Group Practice 8426319104 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
Practice locations: East Brunswick, NJ; Jamesburg, NJ; Howell, NJ; Hoboken, NJ; Farmingdale, NJ; Fairfield, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

86 Brunswick Woods Dr
East Brunswick, NJ 08816
Phone (732) 561-8555

271 US Highway 46
Ste C209
Fairfield, NJ 07004
Phone (732) 561-8555

271 US Highway 46
Ste G201
Fairfield, NJ 07004
Phone (732) 561-8555

203 Candlewood Cmns
Howell, NJ 07731
Phone (732) 561-8555

1696 Route 88
Wall Township, NJ 08724
Phone (732) 561-8555

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1063947828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 E RAILROAD AVE",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088311207",
            "telephone_number": "732-561-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 E RAILROAD AVE",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088311207",
            "telephone_number": "732-561-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "271 Route 46 W Ste G201",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "NJ",
            "postal_code": "070042475",
            "country_code": "US",
            "telephone_number": "732-561-8555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERACORP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2021-11-11",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "KRUTYANSKY",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-207-6834",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NJ",
            "license": "101Y00000X",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "101YA0400X",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "104200000X",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "101YM0800X",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "103T00000X",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NJ",
            "license": "103TP0016X",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "1041X0700X",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "106H00000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TheraCorp Therapeutic Solutions",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "TheraCorp Therapeutic Solutions",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamesburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.