Individual provider Active NPI

Tinamarie Veniscofski, LCADC

  • Addiction (Substance Use Disorder) Counselor
  • Toms River, NJ
National Provider Identifier
1114453479
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00258100 Issued in NJ
Practice address
1163 Route 37 W Ste C2
Toms River, NJ 08755-4975
Phone
(201) 304-3117
Fax
(732) 349-8130
NPI assigned
May 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00258100 NJ Primary

Addresses

Primary practice location

1163 Route 37 W Ste C2
Toms River, NJ 08755-4975

Mailing address

1211 Echo PL
Toms River, NJ 08755-4949
Phone (201) 304-3117

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

LicenseStateTypeSpecialty
37LC00258100NJMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1114453479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 ECHO PL",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087554949",
            "telephone_number": "201-304-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 ROUTE 37 W STE C2",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087554975",
            "telephone_number": "201-304-3117",
            "fax_number": "732-349-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENISCOFSKI",
        "first_name": "TINAMARIE",
        "credential": "LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00258100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.