Active NPI
Sandy Ibrahim, LAC
- Counselor
- Edison, NJ
National Provider Identifier
1073085304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 37AC00439800
- Practice address
- 100 Metroplex Dr
Edison, NJ 08817-2684 - Phone
- (732) 235-8443
- NPI assigned
- Dec 27, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 37AC00439800 | NJ | Primary |
Addresses
Primary practice location
100 Metroplex Dr
Edison, NJ 08817-2684
Mailing address
671 Hoes LN W
Piscataway, NJ 08854-8021
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 |
|---|---|---|---|
| 37AC00439800 | NJ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545868800000",
"number": "1073085304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "671 HOES LN W",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088548021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 METROPLEX DR",
"city": "EDISON",
"state": "NJ",
"postal_code": "088172684",
"telephone_number": "732-235-8443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "SANDY",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-27",
"last_updated": "2018-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NJ",
"license": "37AC00439800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.