Ivelisse A Reyes

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00210800 Issued in NJ

Practice address

339 W 2ND St
Bound Brook, NJ 08805-1833

Phone

(732) 356-1082

Fax

(732) 356-6327

NPI assigned

Mar 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098

  Professional

  Medicare reassignment Care Compare group NPD
• New Day New Beginnings LLC

  • Professional Counselor
  • Edison, NJ
  • NPI 1487590535
  NPD Authorized official

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1124776976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 W 2ND ST",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051833",
            "telephone_number": "732-356-1082",
            "fax_number": "732-356-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 W 2ND ST",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051833",
            "telephone_number": "732-356-1082",
            "fax_number": "732-356-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "IVELISSE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00210800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raritan Valley Psychiatric Care PC
• Meredith Reedy, LSW
• Steven William Rego, LCSW
• Xingcong Ren, C.A.
• Responsible Reliable Community Care Agency
• Jasmine Nicole Reynolds
• Brianna Abigail Richards
• Debra Rimmer, LCSW
• Claire Roberts, LSW
• Lorena Crystal Rodriguez

• Professional Counselor in Bound Brook, NJ
• Providers in Bound Brook, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.

Verify at the official NPI Registry.