Nicole Lynn Owenburg, LAC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00630900 Issued in NJ

Practice address

22 Village CT
Hazlet, NJ 07730-1532

Phone

(732) 639-0232

NPI assigned

Mar 17, 2022

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

Specialty

Mental Health Counselor

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inner Clarity CounselingGroup PAC ID 8022442078, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Inner Clarity Counseling

  • Clinical Social Worker
  • Hazlet, NJ
  • NPI 1154886422
  Medicare reassignment Care Compare group NPD
• Inner Clarity LLC

  • Clinical Social Worker
  • Hazlet, NJ
  • NPI 1639684103
  NPD

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1477201465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WINTERGREEN AVE",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087235541",
            "telephone_number": "323-205-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 VILLAGE CT",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301532",
            "telephone_number": "732-639-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Apple St Ste 113",
            "address_purpose": "LOCATION",
            "city": "Tinton Falls",
            "state": "NJ",
            "postal_code": "077242670",
            "country_code": "US",
            "telephone_number": "732-639-0232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENBURG",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "LAC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00630900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optometric Physicians of Hazlet LLC
• Optometric Physicians of Hazlet, PA
• Optometric Physicians of Middletown PA
• Orthopaedic and Spine Institute of NJ PC
• Denise Marie Ortlieb-Herbert, CCC-SLP
• Timothy J. Owens, O.D.
• Tiffany Palazzo, LAC
• Jacqueline Palladino
• Laura K Palm, LCSW
• Jo Ann F Palumbo, MSW, LCSW

• Mental Health Counselor in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.