Daterra Psychotherapy and Wellness, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00598200 Issued in NJ

Legal business name

DATERRA PSYCHOTHERAPY AND WELLNESS, INC.

Practice address

290 Ferry St BSMT A2
Newark, NJ 07105-3475

Phone

(917) 459-2463

NPI assigned

Oct 26, 2017

Organization subpart

No

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

Authorized official

Name

Susana P Gaia, MA, LMHC, LPCNPI 1689923930

Title

S-Corp Owner/Psychotherapist

Phone

(917) 622-3749

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Susana P. Gaia, MA, LMHC, LPC

  • Mental Health Counselor
  • Newark, NJ
  • NPI 1689923930
  NPD Authorized official

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1467964734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5808 WASHINGTON ST APT 305",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931583",
            "telephone_number": "917-622-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 FERRY ST BSMT A2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053475",
            "telephone_number": "917-459-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DATERRA PSYCHOTHERAPY AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "GAIA",
        "authorized_official_first_name": "SUSANA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "S-CORP OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "917-622-3749",
        "authorized_official_credential": "MA, LMHC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007828-1",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00598200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fatemeh Darvish Zadeh, DMD
• Rajeshree Das, MD
• Sumon Kumar Das, M.D.
• Juliana N Dasilva
• Mohammad Hossein Dastjerdi, MD
• Ramazi Otarovich Datiashvili
• Myrna L Datilus
• David Iosebashvili PC
• Anthony David, LMSW
• Artemio S David Jr., APN

• Professional Counselor in Newark, NJ
• Providers in Newark, 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 Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.