Individual provider Active NPI

Jericka Brown, M.S.

  • Professional Counselor
  • Edgewater Park, NJ
National Provider Identifier
1639611817
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00895200 Issued in NJ
Practice address
1475 Mount Holly Rd Apt P4
Edgewater Park, NJ 08010-2233
Phone
(609) 676-0112
Fax
(609) 265-9268
NPI assigned
Nov 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00895200 NJ Primary

Addresses

Primary practice location

1475 Mount Holly Rd Apt P4
Edgewater Park, NJ 08010-2233

Mailing address

1475 Mount Holly Rd Apt P4
Edgewater Park, NJ 08010-2233
Phone (609) 676-0112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
37PC00895200NJMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1478304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1639611817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 MOUNT HOLLY RD APT P4",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080102233",
            "telephone_number": "609-676-0112",
            "fax_number": "609-265-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MOUNT HOLLY RD APT P4",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080102233",
            "telephone_number": "609-676-0112",
            "fax_number": "609-265-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JERICKA",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-05",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00895200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.