Individual provider Active NPI

Melissa Bratlie, MA, LPC

  • Mental Health Counselor
  • Glassboro, NJ
National Provider Identifier
1487061297
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37PC00877300 Issued in NJ
Practice address
42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone
(844) 422-3632
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37PC00877300 NJ Primary

Addresses

Primary practice location

42 Delsea Dr S
Glassboro, NJ 08028-2621

Mailing address

42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone (844) 422-3632

Other practice location 1

340 S Lemon Ave Unit 9892
Walnut, CA 91789-2706
Phone (415) 651-3458

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240405000572 NJ Practitioner - Mental Health Counselor 8729426010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acenda, Inc.Group PAC ID 0042290678, 27 clinicians

Practice addresses (Care Compare)

42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone (844) 422-3632

42 S Delsea Dr
Glassboro, NJ 08028-2621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
37PC00877300NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Acenda, Inc. Mental Health CurrentSince Jan 23, 2024 Accepting new patients

Locations

42 Delsea Dr S
Glassboro, NJ 08028
Phone (856) 863-0006

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1487061297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DELSEA DR S",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282621",
            "telephone_number": "844-422-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 DELSEA DR S",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282621",
            "telephone_number": "844-422-3632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 S Lemon Ave Unit 9892",
            "address_purpose": "LOCATION",
            "city": "Walnut",
            "state": "CA",
            "postal_code": "917892706",
            "country_code": "US",
            "telephone_number": "415-651-3458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRATLIE",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2022-09-01",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00877300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

Verify at the official NPI Registry.