Active NPI
Ivana Mitic
- Mental Health Counselor
- Belleville, NJ
National Provider Identifier
1336851567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 37AC00623000
- Practice address
- 570 Belleville Ave
Belleville, NJ 07109-1308 - Phone
- (973) 450-3100
- NPI assigned
- Dec 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37AC00623000 | NJ | Primary |
Addresses
Primary practice location
570 Belleville Ave
Belleville, NJ 07109-1308
Mailing address
570 Belleville Ave
Belleville, NJ 07109-1308
Phone (973) 450-3100
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00623000 | NJ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1336851567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 BELLEVILLE AVE",
"city": "BELLEVILLE",
"state": "NJ",
"postal_code": "071091308",
"telephone_number": "973-450-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 BELLEVILLE AVE",
"city": "BELLEVILLE",
"state": "NJ",
"postal_code": "071091308",
"telephone_number": "973-450-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITIC",
"first_name": "IVANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-19",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37AC00623000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.