Gary S Brennan LPC Cadc NCC Psychological and Addiction Services LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00464900 Issued in NJ

Legal business name

GARY S BRENNAN LPC CADC NCC PSYCHOLOGICAL AND ADDICTION SERVICES LLC

Practice address

362 Quaker Church Rd
Randolph, NJ 07869-1455

Phone

(973) 796-8322

Fax

(973) 366-2747

NPI assigned

Jan 22, 2013

Organization subpart

No

Name

Mr. Gary S Brennan, LPC, CADCNPI 1477891745

Title

Registered Agent / Owner

Phone

(973) 796-8322

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary S. Brennan, LPC, CADC

  • Professional Counselor
  • Randolph, NJ
  • NPI 1477891745

  Addiction (Substance Use Disorder), NJ

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in NJ

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 22, 2013.

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1619215993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 QUAKER CHURCH RD",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691455",
            "telephone_number": "973-796-8322",
            "fax_number": "973-366-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 QUAKER CHURCH RD",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691455",
            "telephone_number": "973-796-8322",
            "fax_number": "973-366-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY S BRENNAN LPC CADC NCC PSYCHOLOGICAL AND ADDICTION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "REGISTERED AGENT / OWNER",
        "authorized_official_telephone_number": "973-796-8322",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC, CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37CA00033700",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "S4065",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00464900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Jay Friedman, PH.D.
• Joseph J Fritzky, M.D.
• Diane Frost
• Alan David Furst, M.D.
• Anthony Fusco, D.M.D.
• Gary S. Safier DO, PC
• Kenneth Wesley Gates, PSY.D.
• Sergio C Gatoulis, PHARMD
• Gautam Desai MD PA
• GD NJ Randolph LLC

• All providers in Randolph, NJ
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.