Individual provider Active NPI

Kristen Elizabeth Wavro, LPC

  • Mental Health Counselor
  • Bridgewater, NJ
National Provider Identifier
1437355070
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
500 N Bridge St
Bridgewater, NJ 08807-2135
Phone
(908) 725-2800
Fax
(908) 704-1790
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 37PC01086800 NJ
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

500 N Bridge St
Bridgewater, NJ 08807-2135

Mailing address

500 N Bridge St
Bridgewater, NJ 08807-2135
Phone (908) 725-2800

Other identifiers 2

IdentifierTypeStateIssuer
0023701MedicaidNJ
8363102MedicaidNJ

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
I20250114000278 NJ Practitioner - Mental Health Counselor 7012445422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Somerset TreasurerGroup PAC ID 7315849296, 22 clinicians

Practice addresses (Care Compare)

500 N Bridge St
Bridgewater, NJ 08807-2135
Phone (908) 725-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC01086800NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Somerset Treasurer CurrentSince Dec 1, 2024 Accepting new patients
County of Somerset Treasurer CurrentSince Dec 1, 2024 Accepting new patients

Locations

500 N Bridge St
Bridgewater, NJ 08807
Phone (908) 253-3122

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.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1437355070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAVRO",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC01086800",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023701",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8363102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.