Individual provider Active NPI

Debra Thomason Roelke, PH.D.

  • Mental Health Counselor
  • Morristown, NJ
National Provider Identifier
1245332071
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
35SI00387000 Issued in NJ
Practice address
50 Maple Ave
Morristown, NJ 07960-5296
Phone
(973) 644-0033
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 35SI00387000 NJ Primary

Addresses

Primary practice location

50 Maple Ave
Morristown, NJ 07960-5296

Mailing address

150 Linden Dr
Basking Ridge, NJ 07920-1965
Phone (973) 644-0033

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
I20040521000490 NJ Practitioner - Clinical Psychologist 2466443023 Practice locations: Morristown, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Maple Ave
Morristown, NJ 07960-5296
Phone (973) 644-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00387000NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer M. Priddy, LLC Past Accepting new patients

Organizations & group practices 1

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245332071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LINDEN DR",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201965",
            "telephone_number": "973-644-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MAPLE AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079605296",
            "telephone_number": "973-644-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELKE",
        "first_name": "DEBRA",
        "middle_name": "THOMASON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "35SI00387000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.