Gregory M. Koufacos, M.A., LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00165100 Issued in NJ

Practice address

32 Rector PL
Bloomfield, NJ 07003-4031

Phone

(973) 615-4308

NPI assigned

Dec 10, 2010

Last updated

Dec 10, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1194028365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 RECTOR PL",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 RECTOR PL",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034031",
            "telephone_number": "973-615-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUFACOS",
        "first_name": "GREGORY",
        "middle_name": "M.",
        "credential": "M.A., LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00165100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dhyana Kluth, REVEREND
• Frederick James Kluth
• Stephanie Rose Koeller, LMFT
• Catherine Colette Koenig, MS, LAT, ATC
• Kaitlyn Elizabeth Kolzow, OD
• Evgueni Kovaltchouk, PHARMD
• Wioleta Krzton
• Brooke Elizabeth Kuenzle
• Magdalena Kulesza-Gray, LCADC
• Earl Kusnierz, DO

• Addiction (Substance Use Disorder) Counselor in Bloomfield, NJ
• Providers in Bloomfield, 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 Dec 10, 2010; 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.