Organization Active NPI

Ralph Bianca, PH.D., L.C.S.W., L.C.a.D.C, LLC

  • Clinic/Center
  • Summit, NJ
National Provider Identifier
1437657657
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
44SC05738400 Issued in NJ
Legal business name
RALPH BIANCA, PH.D., L.C.S.W., L.C.A.D.C, LLC
Practice address
800 Old Springfield Ave Apt 7
Summit, NJ 07901-1129
Phone
(908) 312-2019
NPI assigned
Jan 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Ralph Bianca, PHD, LCSW, LCADCNPI 1134630007
Title
Owner
Phone
(908) 312-2019

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 44SC05738400 NJ Primary

Addresses

Primary practice location

800 Old Springfield Ave Apt 7
Summit, NJ 07901-1129

Mailing address

800 Old Springfield Ave Apt 7
Summit, NJ 07901-1129
Phone (908) 312-2019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180410002957 NJ Part B Supplier - Clinic/Group Practice 4981967668 Receives reassigned benefits from 1 practitioner
Practice locations: Summit, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1437657657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 OLD SPRINGFIELD AVE APT 7",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079011129",
            "telephone_number": "908-312-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OLD SPRINGFIELD AVE APT 7",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079011129",
            "telephone_number": "908-312-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH BIANCA, PH.D., L.C.S.W., L.C.A.D.C, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "BIANCA",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-312-2019",
        "authorized_official_credential": "PHD, LCSW, LCADC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "44SC05738400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.