Individual provider Active NPI

Paula Poblocki, LAC

  • Counseling Psychologist
  • Voorhees, NJ
National Provider Identifier
1497470496
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
37AC00674400 Issued in NJ
Practice address
2301 E Evesham Rd Ste 109
Voorhees, NJ 08043-4502
Phone
(856) 433-8615
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 37AC00674400 NJ Primary

Addresses

Primary practice location

2301 E Evesham Rd Ste 109
Voorhees, NJ 08043-4502

Mailing address

1306 Elm Ave
Haddon TWP, NJ 08107-1834
Phone (609) 230-3372

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
37AC00674400NJMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1497470496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 ELM AVE",
            "city": "HADDON TWP",
            "state": "NJ",
            "postal_code": "081071834",
            "telephone_number": "609-230-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD STE 109",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434502",
            "telephone_number": "856-433-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLOCKI",
        "first_name": "PAULA",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NJ",
            "license": "37AC00674400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.