A Space for US Counseling
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Gloucester City, NJ
NPI 1497467708 · NPPES record last updated Aug 21, 2026
Key facts
- NPI
- 1497467708
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- A SPACE FOR US COUNSELING
- Practice address
- 535 Monmouth St
Gloucester City, NJ 08030-1502 - Phone
- (609) 920-3848
- NPI assigned
- Dec 19, 2022
- Organization subpart
- No
Authorized official
- Name
- Keana Reed, MSW, LCSW
- Title
- Owner
- Phone
- (609) 920-3848
Practitioners 2
-
Keana Fairfax, MSW, LCSW
-
Julie Deluccy, LCSW, LCADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230417000536 | NJ | Part B Supplier - Clinic/Group Practice | 0749655157 |
Receives reassigned benefits from 1 practitioner Practice locations: Cherry Hill, NJ |
National Provider Directory
Locations
11 W Ormond Ave
Ste 100A
Cherry Hill, NJ 08002
Phone (609) 902-0636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
535 Monmouth St
Gloucester City, NJ 08030-1502
Mailing address
535 Monmouth St
Gloucester City, NJ 08030-1502
Phone (609) 920-3848
Other providers in Gloucester City, NJ
All providers in Gloucester City, NJ · Mental Health Clinic/Center (Including Community Mental Health Center) 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 Aug 21, 2026. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.