Active NPI
Nicole Bopp, LPC
- Mental Health Counselor
- Medford, NJ
National Provider Identifier
1619340478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 103 Old Marlton Pike Ste 101
Medford, NJ 08055-8772 - Phone
- (856) 223-2222
- NPI assigned
- Nov 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
103 Old Marlton Pike Ste 101
Medford, NJ 08055-8772
Mailing address
103 Old Marlton Pike Ste 101
Medford, NJ 08055-8772
Phone (856) 223-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1619340478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 OLD MARLTON PIKE STE 101",
"city": "MEDFORD",
"state": "NJ",
"postal_code": "080558772",
"telephone_number": "856-223-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 OLD MARLTON PIKE STE 101",
"city": "MEDFORD",
"state": "NJ",
"postal_code": "080558772",
"telephone_number": "856-223-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOPP",
"first_name": "NICOLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-02",
"last_updated": "2024-08-02",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.