Niko B Speed

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

G5C3A4W8 Issued in NJ

Practice address

1907 New Rd
Northfield, NJ 08225-1545

Phone

(609) 645-8884

NPI assigned

Apr 25, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1124874656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251545",
            "telephone_number": "609-645-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251545",
            "telephone_number": "609-645-8884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 S Main Rd",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083607829",
            "country_code": "US",
            "telephone_number": "609-645-8884",
            "fax_number": "609-645-9782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEED",
        "first_name": "NIKO",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "G5C3A4W8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.