Individual provider Active NPI

Deborah Foulkes Bert, LPC, NCC

  • Professional Counselor
  • Maplewood, NJ
National Provider Identifier
1366627713
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00423900 Issued in NJ
Practice address
111 Dunnell Rd Ste 201
Maplewood, NJ 07040-2678
Phone
(973) 330-8123
Fax
(973) 671-4616
NPI assigned
Jan 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00423900 NJ Primary

Addresses

Primary practice location

111 Dunnell Rd Ste 201
Maplewood, NJ 07040-2678

Mailing address

2999 Sanctuary Dr
Clermont, FL 34714-4749
Phone (917) 846-9228

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
I20241223003391 NJ Practitioner - Mental Health Counselor 9537336706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC00423900NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah Foulkes LLC Professional CurrentSince Dec 11, 2011 Accepting new patients

Locations

111 Dunnell Rd
Ste 201
Maplewood, NJ 07040
Phone (973) 330-8123

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1366627713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 SANCTUARY DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347144749",
            "telephone_number": "917-846-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DUNNELL RD STE 201",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402678",
            "telephone_number": "973-330-8123",
            "fax_number": "973-671-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOULKES BERT",
        "first_name": "DEBORAH",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00423900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.