Gary S. Brennan, LPC, CADC
Individual provider Active NPI Professional Counselor · Randolph, NJ
NPI 1477891745 · NPPES record last updated Jan 22, 2013
Key facts
- NPI
- 1477891745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 37PC00464900 (NJ)
- Practice address
- 362 Quaker Church Rd
Randolph, NJ 07869-1455 - Phone
- (973) 796-8322
- Fax
- (973) 366-2747
- NPI assigned
- Jan 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
362 Quaker Church Rd
Randolph, NJ 07869-1455
Phone (973) 796-8322
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240404001978 | NJ | Practitioner - Mental Health Counselor | 3476991894 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37CA00033700 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| S4065 | NJ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary S Brennan LPC Cadc NCC Psychological and Addiction Services LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37CA00033700 | NJ | |
| Professional Counselor | 101YP2500X | 37PC00464900 | NJ | Yes |
| Mental Health Counselor | 101YM0800X | S4065 | NJ |
Addresses
Primary practice location
362 Quaker Church Rd
Randolph, NJ 07869-1455
Mailing address
362 Quaker Church Rd
Randolph, NJ 07869-1455
Phone (973) 796-8322
Other providers in Randolph, NJ
- Joseph Thomas Boorady
- Suzanne M Bowen
- Sharon C. Brackelmanns
- Michael Bravman
- Samantha Breitbart
- Brighter Pathways Counseling
- Angela Kathleen Browne
- Terri Lynn Brucato
- Jennifer E Bua
- Andrei Buna
All providers in Randolph, NJ · Professional Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.