Rose Fedechko, LPC/COTA
Individual provider Active NPI Professional Counselor · Mantua, NJ
NPI 1104600758 · NPPES record last updated Apr 9, 2026
Key facts
- NPI
- 1104600758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37PC01223700 (NJ)
- Practice address
- 550 Bridgeton Pike Ste 2
Mantua, NJ 08051-1318 - Phone
- (856) 746-4244
- NPI assigned
- Aug 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Sun Counseling, LLC
Practice addresses (Care Compare)
Mount Royal, NJ 08061
Phone (856) 746-4244
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260320002307 | NJ | Practitioner - Mental Health Counselor | 6305320946 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC01223700 | NJ | MD | Professional Counselor |
| 46TA09094500 | NJ | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Sun Counseling, LLC | Mental Health | Past | Accepting new patients |
| Reflections Counseling & Wellness | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 46TA09094500 | NJ | |
| Professional Counselor | 101YP2500X | 37PC01223700 | NJ | Yes |
Addresses
Primary practice location
550 Bridgeton Pike Ste 2
Mantua, NJ 08051-1318
Mailing address
PO Box 366
Mount Royal, NJ 08061-0366
Phone (856) 746-4244
Other providers in Mantua, NJ
- Jenni Earp
- Eckerd Corporation
- Elshiva Developmental Services
- Behrad Emami
- Fanelli Chiropractic & Muscle Treatment
- Jennifer V Fratini
- Anthony J Fryckberg
- Susan D Fuchs I
- Nada Ahmed Galad
- Gars Diamond Foundation
All providers in Mantua, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.