Individual provider Active NPI

Jimmy Passe, LPC

  • Professional Counselor
  • Freehold, NJ
National Provider Identifier
1275993941
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00533300 Issued in NJ
Practice address
2 Paragon Way, Suite 800
Freehold, NJ 07728
Phone
(732) 393-8391
Fax
(732) 561-1721
NPI assigned
Feb 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00186400 NJ
Professional Counselor 101YP2500X 37PC00533300 NJ Primary

Addresses

Primary practice location

2 Paragon Way, Suite 800
Freehold, NJ 07728

Mailing address

2 Paragon Way, Suite 800
Freehold, NJ 07728
Phone (732) 393-8391

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
I20250124001939 NJ Practitioner - Mental Health Counselor 4385173079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tree of Life Counseling Center, LLCGroup PAC ID 2668848425, 9 clinicians

Practice addresses (Care Compare)

2 Paragon Way
Suite 800
Freehold, NJ 07728-9573
Phone (732) 393-8391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00186400NJMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tree of Life Counseling Center, LLC Professional CurrentSince Nov 22, 2024 Accepting new patients

Locations

2 Paragon Way
Ste 800
Freehold, NJ 07728
Phone (732) 393-8391

5 Vaughn Dr
Ste 108
Princeton, NJ 08540
Phone (732) 393-8391

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1275993941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON WAY, SUITE 800",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-393-8391",
            "fax_number": "732-561-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARAGON WAY, SUITE 800",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-393-8391",
            "fax_number": "732-561-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSE",
        "first_name": "JIMMY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00186400",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00533300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.