NPIMap

Organization Active NPI

Centra PC

  • Mental Health Counselor
  • Marlton, NJ
National Provider Identifier
1225241995
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CE883152 Issued in NJ
Legal business name
CENTRA PC
Practice address
5000 Sagemore Dr
Suite 205
Marlton, NJ 08053-4307
Phone
(856) 985-3030
Fax
(856) 985-8148
NPI assigned
May 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Kathleen Maguire
Title
Director of Operations
Phone
(856) 985-3030

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CE883152 PA
Mental Health Counselor 101YM0800X CE883152 NJ Primary

Addresses

Primary practice location

5000 Sagemore Dr
Suite 205
Marlton, NJ 08053-4307

Mailing address

5000 Sagemore Dr
Suite 205
Marlton, NJ 08053-4307

Other identifiers 1

IdentifierTypeStateIssuer
CE883152OtherNJGROUP NUMBER

National Provider Directory

National Provider Directory

Locations

5000 Sagemore Dr
Ste 205
Marlton, NJ 08053
Phone (856) 983-3866

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225241995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SAGEMORE DR",
            "address_2": "SUITE 205",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SAGEMORE DR",
            "address_2": "SUITE 205",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534307",
            "telephone_number": "856-985-3030",
            "fax_number": "856-985-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAGUIRE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "856-985-3030",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CE883152",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "CE883152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "CE883152",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.