Individual provider Active NPI

Justin Rosenblum, COUNSELOR INTERN

  • Addiction (Substance Use Disorder) Counselor
  • Cliffwood, NJ
National Provider Identifier
1114735834
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2024-000281 Issued in NJ
Practice address
111 State Route 35
Cliffwood, NJ 07721-1512
Phone
(732) 387-6330
NPI assigned
Dec 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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 2024-000281 NJ Primary

Addresses

Primary practice location

111 State Route 35
Cliffwood, NJ 07721-1512

Mailing address

111 State Route 35
Cliffwood, NJ 07721-1512
Phone (732) 387-6330

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
2024-000281NJMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1114735834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 STATE ROUTE 35",
            "city": "CLIFFWOOD",
            "state": "NJ",
            "postal_code": "077211512",
            "telephone_number": "732-387-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 STATE ROUTE 35",
            "city": "CLIFFWOOD",
            "state": "NJ",
            "postal_code": "077211512",
            "telephone_number": "732-387-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLUM",
        "first_name": "JUSTIN",
        "credential": "COUNSELOR INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "2024-000281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.