Kathereen Pablo, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00790500 Issued in NJ

Practice address

1139 Spruce Dr Ste 2
Mountainside, NJ 07092-2221

Phone

(908) 524-1587

Fax

(908) 731-7102

NPI assigned

Jul 29, 2024

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Theracorp, LLC

  • Clinical Social Worker
  • Jamesburg, NJ
  • NPI 1063947828

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1558190744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BELGROVE DR",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070321505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 SPRUCE DR STE 2",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922221",
            "telephone_number": "908-524-1587",
            "fax_number": "908-731-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABLO",
        "first_name": "KATHEREEN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00790500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelina Okouneva, DO
• Alyssa Grace Oliveira, MS, OTR/L
• Jessica Marie Olsakowski
• Laural Osterhus, LCSW
• James Owen, PSY D
• Liliana I. Palma, PT, DPT
• Ann Pate, MA,,MS,BCBA
• Darshana Patel
• Silquia Patel, LCSW
• Felicia Pecorelli

• Mental Health Counselor in Mountainside, NJ
• Providers in Mountainside, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.