Individual provider Active NPI

Nancy Dawn Wetmore, M.A., LPC

  • Professional Counselor
  • Linwood, NJ
National Provider Identifier
1245320514
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1401 New Rd. - 2ND Floor
Linwood, NJ 08221
Phone
(609) 415-5296
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1401 New Rd. - 2ND Floor
Linwood, NJ 08221

Mailing address

1401 New Rd
Linwood, NJ 08221-1121
Phone (609) 415-5296

Other names 1

  • Ms. Nancy Dawn Basile Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240228000451 NJ Practitioner - Marriage and Family Therapist 4789029919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CCC Counseling IncGroup PAC ID 3870999493, 9 clinicians

Practice addresses (Care Compare)

1401 New Rd
FL 2
Linwood, NJ 08221-1121
Phone (732) 814-4648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Congregation Torath Chaim Raintree CurrentSince Jan 15, 2024 Accepting new patients
CCC Counseling Inc CurrentSince Jan 15, 2024 Accepting new patients

Locations

1401 New Rd
Fl 2
Linwood, NJ 08221
Phone (609) 225-9355

1401 New Rd
Linwood, NJ 08221
Phone (609) 927-5885

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1245320514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 NEW RD",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211121",
            "telephone_number": "609-415-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 NEW RD. - 2ND FLOOR",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "08221",
            "telephone_number": "609-415-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "NANCY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "BASILE",
            "middle_name": "DAWN",
            "prefix": "MS.",
            "credential": "M.A. LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Linwood, NJ

Sources for this page

Verify at the official NPI Registry.