Individual provider Active NPI

Rebecca Logunovskiy, LPC, LMHC

  • Professional Counselor
  • Florham Park, NJ
National Provider Identifier
1093059669
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00522600 Issued in NJ
Practice address
171 Ridgedale Ave Ste J
Florham Park, NJ 07932-1764
Phone
(973) 515-1216
Fax
(973) 515-3108
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 005878 NY
Professional Counselor 101YP2500X 37PC00522600 NJ Primary

Addresses

Primary practice location

171 Ridgedale Ave Ste J
Florham Park, NJ 07932-1764

Mailing address

171 Ridgedale Ave Ste J
Florham Park, NJ 07932-1764
Phone (973) 515-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37PC00522600NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapymilestones II Mental Health CurrentSince Aug 1, 2022 Accepting new patients
Psychotherapy Milestones LLC Professional PastSince Jun 4, 2023 Accepting new patients

Locations

470 Ridgedale Ave
Ste 3
East Hanover, NJ 07936
Phone (973) 515-1216

171 Ridgedale Ave
Ste J
Florham Park, NJ 07932
Phone (973) 377-6327

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1093059669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 RIDGEDALE AVE STE J",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321764",
            "telephone_number": "973-515-1216",
            "fax_number": "973-515-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 RIDGEDALE AVE STE J",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321764",
            "telephone_number": "973-515-1216",
            "fax_number": "973-515-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGUNOVSKIY",
        "first_name": "REBECCA",
        "credential": "LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005878",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00522600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

Verify at the official NPI Registry.