Individual provider Active NPI

Jessica Romain, LPC

  • Professional Counselor
  • Clark, NJ
National Provider Identifier
1326534983
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00767100 Issued in NJ
Practice address
67 Walnut Ave Ste 207
Clark, NJ 07066-1640
Phone
(732) 982-2888
Fax
(847) 859-5885
NPI assigned
Jul 6, 2018
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37AC00410200 NJ
Professional Counselor 101YP2500X 37PC00767100 NJ Primary

Addresses

Primary practice location

67 Walnut Ave Ste 207
Clark, NJ 07066-1640

Mailing address

4 Century Dr Ste 100
Parsippany, NJ 07054-4606
Phone (732) 982-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240320000174 NJ Practitioner - Mental Health Counselor 3476990979 Reassigns benefits to 1 organization
I20240723000564 NJ Practitioner - Marriage and Family Therapist 3476990979 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
Group practices
New Jersey Behavioral Health PCGroup PAC ID 4284001025, 127 clinicians

Practice addresses (Care Compare)

4 Century Dr
Suite 100
Parsippany, NJ 07054-4606
Phone (732) 982-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37AC00410200NJMDMental Health Counselor
37PC00767100NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Behavioral Health P.C CurrentSince Feb 5, 2024 Accepting new patients
Family Service League,Inc. CurrentSince May 7, 2024 Accepting new patients
PHC of Buffalo Grove Clinical Psychology PastSince Feb 5, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

150 Morristown Rd
Ste 108
Bernardsville, NJ 07924
Phone (844) 259-2366

440 Franklin St
Ste 200
Bloomfield, NJ 07003
Phone (973) 746-0800

67 Walnut Ave
Ste 207
Clark, NJ 07066
Phone (267) 800-6027

4 Century Dr
Ste 100
Parsippany, NJ 07054
Phone (844) 296-0630

88 Princeton Hightstown Rd
Ste 202
West Windsor, NJ 08550
Phone (609) 497-4900

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jessicaroman@148376.advancedmd-direct.com

Organizations & group practices 3

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1326534983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CENTURY DR STE 100",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070544606",
            "telephone_number": "732-982-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE STE 207",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "732-982-2888",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAIN",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00410200",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00767100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

Verify at the official NPI Registry.