Active NPI
Roman Petrocelli, MA
- Professional Counselor
- Florham Park, NJ
National Provider Identifier
1457678013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00496400
- Practice address
- 248 Columbia Tpke
Florham Park, NJ 07932-1210 - Phone
- (973) 464-5377
- NPI assigned
- Apr 22, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 37PC00496400 | NJ | Primary |
Addresses
Primary practice location
248 Columbia Tpke
Florham Park, NJ 07932-1210
Mailing address
248 Columbia Tpke
Florham Park, NJ 07932-1210
Phone (973) 464-5377
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00496400 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521763200000",
"number": "1457678013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 COLUMBIA TPKE",
"city": "FLORHAM PARK",
"state": "NJ",
"postal_code": "079321210",
"telephone_number": "973-464-5377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 COLUMBIA TPKE",
"city": "FLORHAM PARK",
"state": "NJ",
"postal_code": "079321210",
"telephone_number": "973-464-5377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROCELLI",
"first_name": "ROMAN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-22",
"last_updated": "2018-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00496400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florham Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.