NPIMap

Organization Active NPI

Lakeside Counseling Associates, LLC

  • Professional Counselor
  • Sparta, NJ
National Provider Identifier
1578010674
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LAKESIDE COUNSELING ASSOCIATES, LLC
Practice address
9 Fishers LN Ste E
Sparta, NJ 07871-2441
Phone
(973) 600-3558
NPI assigned
Sep 6, 2016
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Melissa PirnosNPI 1558712075
Title
Director/Owner
Phone
(973) 600-3558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

9 Fishers LN Ste E
Sparta, NJ 07871-2441

Mailing address

9 Fishers LN Ste E
Sparta, NJ 07871-2441

Other practice location 1

191 Woodport Rd Ste 206
Sparta, NJ 07871-2641
Phone (973) 726-4533

Other practice location 2

30 Moran St
Newton, NJ 07860-1832
Phone (973) 726-4533

Other practice location 3

351 Sparta Ave Ste 102
Sparta, NJ 07871-1160
Phone (973) 726-4533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170619001045 NJ Part B Supplier - Clinic/Group Practice 0840568754 Receives reassigned benefits from 33 practitioners
Practice locations: Newton, NJ; Sparta, NJ

National Provider Directory

National Provider Directory

Locations

9 Fishers Ln
Ste E
Sparta, NJ 07871
Phone (973) 600-3558

191 Woodport Rd
Ste 206
Sparta, NJ 07871
Phone (973) 726-4533

350 Sparta Ave
Ste C2A
Sparta, NJ 07871
Phone (973) 726-0617

351 Sparta Ave
Ste 102
Sparta, NJ 07871
Phone (973) 726-4533

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1578010674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 FISHERS LN STE E",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 FISHERS LN STE E",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712441",
            "telephone_number": "973-600-3558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Woodport Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "NJ",
            "postal_code": "078712641",
            "country_code": "US",
            "telephone_number": "973-726-4533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Moran St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "NJ",
            "postal_code": "078601832",
            "country_code": "US",
            "telephone_number": "973-726-4533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "351 Sparta Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "NJ",
            "postal_code": "078711160",
            "country_code": "US",
            "telephone_number": "973-726-4533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKESIDE COUNSELING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "PIRNOS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "973-600-3558"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.