Active NPI
Mignolia Placencia
- Professional Counselor
- Wayne, NJ
National Provider Identifier
1124616446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37AC00473300
- Practice address
- 1401 Valley Rd
Wayne, NJ 07470-2073 - Phone
- (973) 368-7781
- NPI assigned
- Jan 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37AC00473300 | NJ | Primary |
Addresses
Primary practice location
1401 Valley Rd
Wayne, NJ 07470-2073
Mailing address
113 Knolls Rd
Bloomingdale, NJ 07403-1513
Phone (862) 668-1348
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
113 Knolls Rd
Bloomingdale, NJ 07403-1513
34 Walnut Park LN
Milton, NY 12547-5266
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00473300 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Path Wellness & Counseling LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Bloomingdale, NJ
- NPI 1992509160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609632000000",
"number": "1124616446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 KNOLLS RD",
"city": "BLOOMINGDALE",
"state": "NJ",
"postal_code": "074031513",
"telephone_number": "862-668-1348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 VALLEY RD",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702073",
"telephone_number": "973-368-7781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLACENCIA",
"first_name": "MIGNOLIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-03",
"last_updated": "2021-01-03",
"certification_date": "2021-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37AC00473300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2021; 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.