The Pastors Lounge LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

THE PASTORS LOUNGE LLC

Practice address

11 Tamarack Rd
Edison, NJ 08820-3630

Phone

(908) 844-1080

NPI assigned

Oct 12, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Sheridan Jenice Tennant-Straube

Title

Co Owner and Clinician

Phone

(908) 844-1080

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheridan Jenice Tennant, LPC

  • Professional Counselor
  • Watchung, NJ
  • NPI 1295244150
  NPD

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

{
    "created_epoch": "1728691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728691200000",
    "number": "1093535395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 BENNETTS LN",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735051",
            "telephone_number": "908-844-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 TAMARACK RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203630",
            "telephone_number": "908-844-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PASTORS LOUNGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-12",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A",
        "authorized_official_last_name": "TENNANT-STRAUBE",
        "authorized_official_first_name": "SHERIDAN",
        "authorized_official_middle_name": "JENICE",
        "authorized_official_title_or_position": "CO OWNER AND CLINICIAN",
        "authorized_official_telephone_number": "908-844-1080",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2024; 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.