Active NPI
Raymond Costa, LPC
- Professional Counselor
- Matawan, NJ
National Provider Identifier
1093083149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00394900
- Practice address
- 4122 Route 516
Suite C and D
Matawan, NJ 07747-7022 - Phone
- (732) 679-4500
- Fax
- (732) 679-4549
- NPI assigned
- Dec 5, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00394900 | NJ | Primary |
Addresses
Primary practice location
4122 Route 516
Suite C and D
Matawan, NJ 07747-7022
Mailing address
4122 Route 516
Suite C and D
Matawan, NJ 07747-7022
Phone (732) 679-4500
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 |
|---|---|---|---|
| 37PC00394900 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stress Care Medical Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Manalapan, NJ
- NPI 1386270890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1093083149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4122 ROUTE 516",
"address_2": "SUITE C AND D",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "077477022",
"telephone_number": "732-679-4500",
"fax_number": "732-679-4549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4122 ROUTE 516",
"address_2": "SUITE C AND D",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "077477022",
"telephone_number": "732-679-4500",
"fax_number": "732-679-4549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "RAYMOND",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00394900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matawan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.