NPIMap

Organization Active NPI

Counseling Center at Clark, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Succasunna, NJ
National Provider Identifier
1366222754
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
COUNSELING CENTER AT CLARK, LLC
Practice address
66 Sunset Strip Ste 302
Succasunna, NJ 07876-1362
Phone
(561) 318-4400
NPI assigned
Oct 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Jason Usilton
Title
Director of RCM
Phone
(561) 318-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

66 Sunset Strip Ste 302
Succasunna, NJ 07876-1362

Mailing address

66 Sunset Strip Ste 302
Succasunna, NJ 07876-1362

Other names 1

  • Counseling Center at Clark - Roxbury Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2163389Counseling Center at Roxbury, LLC, the66 Sunset Strip, Succasunna, NJ 07876Certificate of waiverMar 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Counseling Center at Clark - Cherry Hill7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1366222754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 SUNSET STRIP STE 302",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SUNSET STRIP STE 302",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761362",
            "telephone_number": "561-318-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CENTER AT CLARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "USILTON",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "561-318-4400"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling Center at Clark - Roxbury",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Succasunna, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.