Christine Leotta-Selby, LPC, LCADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Beachwood, NJ
NPI 1265660955 · NPPES record last updated Apr 22, 2020
Key facts
- NPI
- 1265660955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 37LC00141500 (NJ)
- Practice address
- 625 Route 9
Beachwood, NJ 08722-4007 - Phone
- (732) 580-6619
- NPI assigned
- Jul 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2001
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
625 Atlantic City Blvd
Beachwood, NJ 08722-4007
Phone (732) 580-6619
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250411002129 | NJ | Practitioner - Mental Health Counselor | 8022532035 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00141500 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| 37PC00453600 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creative Life Strategies, LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Maria Vernachio Counseling, LLC | Past |
Accepting new patients |
Locations
625 Route 9
Beachwood, NJ 08722
Phone (732) 580-6619
625 Route 9
#2
Beachwood, NJ 08722
Phone (609) 361-4263
625 Atlantic City Blvd
Beachwood, NJ 08722
Phone (732) 580-6619
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00453600 | NJ | |
| School Counselor | 101YS0200X | NJ | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00141500 | NJ | Yes |
Addresses
Primary practice location
625 Route 9
Beachwood, NJ 08722-4007
Mailing address
PO Box 110
Bayville, NJ 08721-0110
Phone (732) 580-6619
Other practice location 1
1044 Lacey Rd
Forked River, NJ 08731-1051
Phone (732) 580-6619
Other names
- Ms. Christine Leotta
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Bayville | Direct |
Other providers in Beachwood, NJ
- Health First Pharmacy, LLC
- Patti Herrmann
- Richard Holligan
- Nichole Christina Labollita
- Neil Jack Lavender
- Sarah Ann Liguori
- Leonard Angelo Luizzi Jr.
- Maria Vernachio Counseling, LLC
- Nicola M McCann
- National Mentor Healthcare, LLC
All providers in Beachwood, NJ · Addiction (Substance Use Disorder) Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.