Active NPI
Emil Affsa III, LPC
- Counseling Psychologist
- Elizabeth, NJ
National Provider Identifier
1457556847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 37PC00333500
- Practice address
- 655 E Jersey St
Dept. of Behavioral Health & Psychiatry
Elizabeth, NJ 07206-1259 - Phone
- (908) 994-5000
- Fax
- (908) 994-5000
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 37PC00333500 | NJ | Primary |
Addresses
Primary practice location
655 E Jersey St
Dept. of Behavioral Health & Psychiatry
Elizabeth, NJ 07206-1259
Mailing address
655 E Jersey St
Dept. of Behavioral Health & Psychiatry
Elizabeth, NJ 07206-1259
Phone (908) 994-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37PC0003335000 | Other | NJ | STATE LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00333500 | NJ | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457556847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 E JERSEY ST",
"address_2": "DEPT. OF BEHAVIORAL HEALTH & PSYCHIATRY",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072061259",
"telephone_number": "908-994-5000",
"fax_number": "908-994-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 E JERSEY ST",
"address_2": "DEPT. OF BEHAVIORAL HEALTH & PSYCHIATRY",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072061259",
"telephone_number": "908-994-5000",
"fax_number": "908-994-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AFFSA",
"first_name": "EMIL",
"name_suffix": "III",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NJ",
"license": "37PC00333500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "37PC0003335000",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.