NPIMap

Organization Active NPI

Integrated Care Concepts & Consultation, LLC

  • Professional Counselor
  • Eatontown, NJ
National Provider Identifier
1639236516
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
INTEGRATED CARE CONCEPTS & CONSULTATION, LLC
Practice address
615 Hope Rd
Building 1B, Second Floor
Eatontown, NJ 07724-1277
Phone
(732) 389-0697
Fax
(732) 389-0611
NPI assigned
Jan 2, 2007
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
John Larry Thompson, L.C.S.W.NPI 1538285911
Title
Owner
Phone
(732) 389-0697

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

615 Hope Rd
Building 1B, Second Floor
Eatontown, NJ 07724-1277

Mailing address

615 Hope Rd
Building 1B, Second Floor
Eatontown, NJ 07724-1277
Phone (732) 389-0697

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250507000726 NJ Part B Supplier - Clinic/Group Practice 6709303357 Receives reassigned benefits from 23 practitioners
Practice locations: Eatontown, NJ

National Provider Directory

National Provider Directory

Locations

615 Hope Rd
Bldg 1B
Eatontown, NJ 07724
Phone (732) 389-0697

615 Hope Rd
Ste 5B
Tinton Falls, NJ 07724
Phone (732) 389-0697

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1639236516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD",
            "address_2": "BUILDING 1B, SECOND FLOOR",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD",
            "address_2": "BUILDING 1B, SECOND FLOOR",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CARE CONCEPTS & CONSULTATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-389-0697",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.