Krystyna Cechulski, LCSW

Key facts

NPI

1508448796

Entity type

Individual (NPI type 1)

Primary specialty

Social Worker 104100000X

License

44SC05993500 (NJ)

Practice address

814 Navesink Ave
Ocean Gate, NJ 08740-1377

Phone

(848) 373-6500

NPI assigned

Apr 27, 2021

Sex

Female

Sole proprietor

No

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.

• Grounded Soul Counseling & Wellness Mental Health Counselor · Toms River, NJ · NPI 1265153985
  NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 1, 2022.

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1508448796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1037",
            "city": "OCEAN GATE",
            "state": "NJ",
            "postal_code": "087401037",
            "telephone_number": "848-373-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 NAVESINK AVE",
            "city": "OCEAN GATE",
            "state": "NJ",
            "postal_code": "087401377",
            "telephone_number": "848-373-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Main St",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087537420",
            "country_code": "US",
            "telephone_number": "732-600-0971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CECHULSKI",
        "first_name": "KRYSTYNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC05993500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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