Individual provider Active NPI

Joelle Frances Dere, LCSW

  • Mental Health Counselor
  • Verona, NJ
National Provider Identifier
1336784925
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC05803400 Issued in NJ
Practice address
25 Pompton Ave
Verona, NJ 07044-2941
Phone
(973) 862-0673
NPI assigned
Nov 7, 2019
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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 44SC05803400 NJ Primary
Clinical Social Worker 1041C0700X 44SC05803400 NJ

Addresses

Primary practice location

25 Pompton Ave
Verona, NJ 07044-2941

Mailing address

19 Cypress Ave
Verona, NJ 07044-1909
Phone (973) 862-0673

Other practice location 1

75 E Northfield Rd
Livingston, NJ 07039-4532
Phone (973) 436-1400

Other practice location 2

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05803400NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Align Counseling Center Mental Health Current 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, 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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1336784925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CYPRESS AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441909",
            "telephone_number": "973-862-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 POMPTON AVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442941",
            "telephone_number": "973-862-0673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 E Northfield Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070394532",
            "country_code": "US",
            "telephone_number": "973-436-1400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Diamond Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Berkeley Heights",
            "state": "NJ",
            "postal_code": "079222104",
            "country_code": "US",
            "telephone_number": "908-273-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERE",
        "first_name": "JOELLE",
        "middle_name": "FRANCES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05803400",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05803400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.