Active NPI
Erica Mickens
- Mental Health Counselor
- Passaic, NJ
National Provider Identifier
1174399265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 37PC00823300
- Practice address
- 83 Passaic St Apt 4
Passaic, NJ 07055-8347 - Phone
- (862) 221-8118
- NPI assigned
- Nov 29, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37PC00823300 | NJ | Primary |
Addresses
Primary practice location
83 Passaic St Apt 4
Passaic, NJ 07055-8347
Mailing address
83 Passaic St Apt 4
Passaic, NJ 07055-8347
Phone (862) 221-8118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00823300 | NJ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1174399265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83 PASSAIC ST APT 4",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070558347",
"telephone_number": "862-221-8118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 PASSAIC ST APT 4",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070558347",
"telephone_number": "862-221-8118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKENS",
"first_name": "ERICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-29",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37PC00823300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.