Individual provider Active NPI

Kerry Gorbos

  • Addiction (Substance Use Disorder) Counselor
  • Jersey City, NJ
National Provider Identifier
1417426255
Registry record updated Nov 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
395 Grand St FL 2
Jersey City, NJ 07302-4238
Phone
(201) 915-2247
NPI assigned
Nov 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

395 Grand St FL 2
Jersey City, NJ 07302-4238

Mailing address

395 Grand St FL 2
Jersey City, NJ 07302-4238

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1542931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542931200000",
    "number": "1417426255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 GRAND ST FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 GRAND ST FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024238",
            "telephone_number": "201-915-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORBOS",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-23",
        "last_updated": "2018-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2018; 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.