Shelly Jecc Espejo, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC01062200 Issued in NJ

Practice address

183 S Orange Ave
Newark, NJ 07103-2757

Phone

(800) 969-5300

NPI assigned

Jun 9, 2020

Sex

Female

Sole proprietor

No

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rutgers Health - Behavioral Health

  • Psychiatry Physician
  • Cherry Hill, NJ
  • NPI 1891956298

  NJ

  Medicare reassignment NPD
• Rutgers Health - Behavioral Health

  • Psychiatry Physician
  • Piscataway, NJ
  • NPI 1144267337
  NPD

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1568087203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 HOES LN W",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088548021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "800-969-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPEJO",
        "first_name": "SHELLY",
        "middle_name": "JECC",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC01062200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Escobar, LAC
• Jared Alexander Escobar, MD
• Marcelo Esguerra Jr., P.T.
• Aida Eshak, DMD
• Sarah Eskander
• Marling Susana Espinosa
• Eduardo Antonio Espinoza Olortegui, M.D.
• Maria C Espiritu-Fuller, M.D.
• Lilia Espiritu, NP
• Jonathan Esposito, CRNA

• All providers in Newark, NJ
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.