Clarice Perdomo, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00683000 Issued in NJ

Practice address

75 Essex St Ste 110
Hackensack, NJ 07601-4034

Phone

(201) 488-6678

Fax

(201) 342-4346

NPI assigned

Aug 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098

  Professional

  Medicare reassignment NPD
• Specialized Therapy Associates

  • Adult Mental Health Clinic/Center
  • Hackensack, NJ
  • NPI 1407953896
  NPD (past)

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1467009076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3016",
            "city": "SOUTH HACKENSACK",
            "state": "NJ",
            "postal_code": "076061016",
            "telephone_number": "201-488-6678",
            "fax_number": "201-342-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ESSEX ST STE 110",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014034",
            "telephone_number": "201-488-6678",
            "fax_number": "201-342-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDOMO",
        "first_name": "CLARICE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00683000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria K Pena, DO
• Peniel Pharmacy
• People Care New Jersey Inc.
• Carmen Cecilia Peralta, FNP
• Stephen Percy Jr., MD
• Kimberly J Perdomo, AGPCNP-BC
• Stephen Gomes Pereira, MD
• Irina Perelman, O.D.
• Adriana M. Perez, M.D.
• Alexa M Perez

• Professional Counselor in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.