Individual provider Active NPI

Mikaela M. Morcombe, LPC

  • Professional Counselor
  • Moorestown, NJ
National Provider Identifier
1083222590
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00948400 Issued in NJ
Practice address
740 Marne Hwy Ste 108
Moorestown, NJ 08057-3126
Phone
(732) 982-2888
NPI assigned
Jul 21, 2020
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00948400 NJ Primary

Addresses

Primary practice location

740 Marne Hwy Ste 108
Moorestown, NJ 08057-3126

Mailing address

740 Marne Hwy Ste 108
Moorestown, NJ 08057-3126
Phone (732) 982-2888

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

LicenseStateTypeSpecialty
37PC00948400NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
PHC of Buffalo Grove Clinical Psychology CurrentSince Aug 1, 2020 Accepting new patients
New Jersey Behavioral Health P.C CurrentSince Jan 1, 2023 Accepting new patients

Locations

175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125

740 Marne Hwy
Ste 108
Moorestown, NJ 08057
Phone (732) 644-3008

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.mikaelamorcombe@148376.advancedmd-direct.com

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1083222590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 MARNE HWY STE 108",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573126",
            "telephone_number": "732-982-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MARNE HWY STE 108",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573126",
            "telephone_number": "732-982-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORCOMBE",
        "first_name": "MIKAELA",
        "middle_name": "M.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00948400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.