Kelly Theresa Boccio, MA, NCC, LAC
Individual provider Active NPI Counselor · Ramsey, NJ
NPI 1124630355 · NPPES record last updated Aug 19, 2020
Key facts
- NPI
- 1124630355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 37AC00531400 (NJ)
- Practice address
- 79 N Franklin Tpke Ste 107
Ramsey, NJ 07446-2029 - Phone
- (973) 477-5480
- NPI assigned
- Aug 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00531400 | NJ | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | 37AC00531400 | NJ | Yes |
Addresses
Primary practice location
79 N Franklin Tpke Ste 107
Ramsey, NJ 07446-2029
Mailing address
32 Powell Rd
Allendale, NJ 07401-2011
Phone (718) 619-5454
Other providers in Ramsey, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.