Individual provider Active NPI

Bertha Pollard, LCADC

  • Addiction (Substance Use Disorder) Counselor
  • South Amboy, NJ
National Provider Identifier
1487355517
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00309500 Issued in NJ
Practice address
901 Ernston Rd
South Amboy, NJ 08879-2000
Phone
(732) 654-3110
NPI assigned
Mar 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL06808500 NJ
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00309500 NJ Primary

Addresses

Primary practice location

901 Ernston Rd
South Amboy, NJ 08879-2000

Mailing address

4141 Bayberry CT
Monmouth Junction, NJ 08852-2125
Phone (732) 766-7065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37LC00309500NJMDAddiction (Substance Use Disorder) Counselor
44SL06808500NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1487355517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 BAYBERRY CT",
            "city": "MONMOUTH JUNCTION",
            "state": "NJ",
            "postal_code": "088522125",
            "telephone_number": "732-766-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ERNSTON RD",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792000",
            "telephone_number": "732-654-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "BERTHA",
        "credential": "LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06808500",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00309500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.