Mary Jean Jose, LAC
Individual provider Active NPI Mental Health Counselor · River Vale, NJ
NPI 1619625563 · NPPES record last updated Mar 10, 2022
Key facts
- NPI
- 1619625563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 37AC00490600 (NJ)
- Practice address
- 619 Bernita Dr
River Vale, NJ 07675-5905 - Phone
- (732) 689-0171
- NPI assigned
- Mar 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00490600 | NJ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anxiety Leader LLC | Mental Health | Current |
Accepting new patients |
Interoperability endpoints
- mjose@anxietyleader.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37AC00490600 | NJ | Yes |
Addresses
Primary practice location
619 Bernita Dr
River Vale, NJ 07675-5905
Mailing address
619 Bernita Dr
River Vale, NJ 07675-5905
Phone (732) 689-0171
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Mjose@anxietyleader.com | Direct |
Other providers in River Vale, NJ
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- Abanoub Jad
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- Rachel Helene Josephs
- Yonina Kaplan
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All providers in River Vale, NJ · Mental Health Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.