Active NPI
Jermaine Hibbert, LAC
- Professional Counselor
- Clifton, NJ
National Provider Identifier
1417711367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 935 Allwood Rd Ste 300
Clifton, NJ 07012-1988 - Phone
- (862) 930-5700
- NPI assigned
- Feb 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
935 Allwood Rd Ste 300
Clifton, NJ 07012-1988
Mailing address
25 Dodd St
Nutley, NJ 07110-1715
Phone (917) 244-0885
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
935 Allwood Rd
Suite 300
Clifton, NJ 07012-1988
Phone (862) 930-5700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Time to Heal | Professional | Current | Accepting new patients |
| Allwood Behavioral Health | Professional | Current | Accepting new patients |
Locations
935 Allwood Rd
Ste 300
Clifton, NJ 07012
Phone (862) 930-5700
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Clifton, NJ
- NPI 1851066682
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707696000000",
"number": "1417711367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 DODD ST",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071101715",
"telephone_number": "917-244-0885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 ALLWOOD RD STE 300",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070121988",
"telephone_number": "862-930-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIBBERT",
"first_name": "JERMAINE",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-12",
"last_updated": "2024-02-12",
"certification_date": "2024-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.