Anastasia Matina Maravelias-Kakos, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00046000 Issued in NJ

Practice address

232 Norwood Ave
Counseling & Psychotherapy for Change, LLC
West Long Branch, NJ 07764-1859

Phone

(732) 263-1515

Fax

(732) 263-9555

NPI assigned

Jan 8, 2008

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

Other names 1

• Mrs. Stacy Maravelias-Kakos Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1598940587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NORWOOD AVE",
            "address_2": "COUNSELING & PSYCHOTHERAPY FOR CHANGE, LLC",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641859",
            "telephone_number": "732-263-1515",
            "fax_number": "732-263-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 NORWOOD AVE",
            "address_2": "COUNSELING & PSYCHOTHERAPY FOR CHANGE, LLC",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641859",
            "telephone_number": "732-263-1515",
            "fax_number": "732-263-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVELIAS-KAKOS",
        "first_name": "ANASTASIA",
        "middle_name": "MATINA",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00046000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "MARAVELIAS-KAKOS",
            "prefix": "MRS.",
            "credential": "MA, LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sherif Malek, MD
• Aqsa Malik
• Kathy L. Maloney, NP
• Tara Mango, AUD
• Brianna Eunice Marangiello, LSW, MSW
• Steven Jay Marder, DPM
• Arthur Donato Mari, M.D.
• Mark a. Nasr DDS LLC
• Lacy Marrucca, LPC
• Robert A. Massaro, M.D.

• Professional Counselor in West Long Branch, NJ
• Providers in West Long Branch, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.