Shonda Renee Brooks, MA, LAC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00498500 Issued in NJ

Practice address

1007 Cooper St
Edgewater Park, NJ 08010-1757

Phone

(609) 447-1280

NPI assigned

May 7, 2020

Last updated

May 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• River in Eden Counseling, LLC

  • Mental Health Counselor
  • Cherry Hill, NJ
  • NPI 1821661653
  NPD Authorized official

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1376165811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080100071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 COOPER ST",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080101757",
            "telephone_number": "609-447-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "SHONDA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MA, LAC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00498500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Abrahams
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• Gwendolyn Renee Bonner
• Jericka Brown, M.S.
• Miatta Brownson
• Mary Capozzoli, RN
• Cmfort Care at Home LLC
• Shataya M Crawley

• Mental Health Counselor in Edgewater Park, NJ
• Providers in Edgewater Park, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.