Individual provider Active NPI

Debra Panciello, LAC

  • Professional Counselor
  • Piscataway, NJ
National Provider Identifier
1376053744
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37AC00316900 Issued in NJ
Practice address
671 Hoes Lane West
Piscataway, NJ 08855
Phone
(732) 235-4434
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37AC00316900 NJ Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00214800 NJ

Addresses

Primary practice location

671 Hoes Lane West
Piscataway, NJ 08855

Mailing address

671 Hoes Lane West
Piscataway, NJ 08855

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

LicenseStateTypeSpecialty
37LC00214800NJMDAddiction (Substance Use Disorder) Counselor
37AC00316900NJMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1376053744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 HOES LANE WEST",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "08855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 HOES LANE WEST",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "08855",
            "telephone_number": "732-235-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCIELLO",
        "first_name": "DEBRA",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00316900",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00214800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.