Sally Ann Goncalves, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00813600 Issued in NJ

Practice address

9 Briar LN
Nutley, NJ 07110-3001

Phone

(973) 623-0600

NPI assigned

Nov 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• Behavioral Health Associates of New Jersey LLC

  • Community/Behavioral Health Agency
  • Nutley, NJ
  • NPI 1932956703
  Medicare reassignment NPD Authorized official
• Integrity, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newark, NJ
  • NPI 1487253779
  Medicare reassignment NPD
• Integrity, Inc

  • Adult Mental Health Clinic/Center
  • Newark, NJ
  • NPI 1164092631
  NPD
• Advanced Rehab Solutions LLC

  • Physical Therapy Clinic/Center
  • Springfield, NJ
  • NPI 1932380888
  NPD (past)

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1124785316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BRIAR LN",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103001",
            "telephone_number": "973-623-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BRIAR LN",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103001",
            "telephone_number": "973-623-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCALVES",
        "first_name": "SALLY ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00418500",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00813600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Glodava, DPT
• William A Goedecker, PHARMACIST
• Golden Bridge Therapy Group
• Joshua Michael Goldschmidt, O.D.
• Annlee Goldstein, LCSW
• Diana Gonzalez
• Yolanda Gonzalez, LCSW
• Angeline Graff, LCSW
• Andreas Graham, LAC
• Great Expectations Clinical and Support Services LLC

• Professional Counselor in Nutley, NJ
• Providers in Nutley, 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 Feb 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.