Seraphim Chemodakov, MA LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00445600 Issued in NJ

Practice address

15 W Prospect St Ste 2
East Brunswick, NJ 08816-2161

Phone

(732) 254-0600

NPI assigned

Dec 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Startnewu LLCGroup PAC ID 8123555232, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Startnewu LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manalapan, NJ
  • NPI 1740943455

  NJ

  Medicare reassignment Care Compare group NPD
• Center for Therapy & Counseling Services, LLC

  • Clinical Social Worker
  • East Brunswick, NJ
  • NPI 1487887915
  NPD (past)

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1104397967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 IRENE BLVD",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077312417",
            "telephone_number": "732-580-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W PROSPECT ST STE 2",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162161",
            "telephone_number": "732-254-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEMODAKOV",
        "first_name": "SERAPHIM",
        "credential": "MA LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00445600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anwesha Chaudhuri, PSYD
• Rubina Chauhan-D'Emilio, DPT
• Natasha Rani Chawla, O.D
• Chelsea at East Brunswick
• Heather Chelton, LCSW
• Jianzhong Chen
• Qiong Chen, OD
• Stephanie Chen
• William Yuen Chen, MD
• Nicole Cherbakova, MSW, LSW

• All providers in East Brunswick, NJ
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.