Individual provider Active NPI

Susan J. Conley, LPC, LCADC

  • Mental Health Counselor
  • Brick, NJ
National Provider Identifier
1407970718
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37PC00150200 Issued in NJ
Practice address
270 Chambersbridge Rd
Brick, NJ 08723-2805
Phone
(732) 920-2700
Fax
(732) 262-0707
NPI assigned
Mar 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37PC00150200 NJ Primary

Addresses

Primary practice location

270 Chambersbridge Rd
Brick, NJ 08723-2805

Mailing address

270 Chambersbridge Rd
Brick, NJ 08723-2805
Phone (732) 920-2700

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
I20240221000921 NJ Practitioner - Marriage and Family Therapist 8729124037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Street Counseling, LLCGroup PAC ID 7113317694, 9 clinicians

Practice addresses (Care Compare)

1540 Kuser Rd
Suite A3
Hamilton, NJ 08619-3828
Phone (609) 208-3053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Counseling, LLC CurrentSince Jan 15, 2024 Accepting new patients

Locations

1540 Kuser Rd
Ste A3
Trenton, NJ 08619
Phone (609) 208-3053

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407970718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CHAMBERSBRIDGE RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087232805",
            "telephone_number": "732-920-2700",
            "fax_number": "732-262-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CHAMBERSBRIDGE RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087232805",
            "telephone_number": "732-920-2700",
            "fax_number": "732-262-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "SUSAN",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "LPC, LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00150200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.