NPIMap

Organization Active NPI

Child Resiliency

  • Mental Health Counselor
  • Newark, DE
National Provider Identifier
1649791922
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2017603208 Issued in DE
Legal business name
CHILD RESILIENCY
Practice address
69 Brookfield Dr
Newark, DE 19702-5942
Phone
(302) 235-9159
NPI assigned
Jun 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Authorized official

Name
Stephanie Nicole Juarez, LCSWNPI 1083145932
Title
Therapist
Phone
(302) 235-9159

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 2017603208 DE Primary

Addresses

Primary practice location

69 Brookfield Dr
Newark, DE 19702-5942

Mailing address

69 Brookfield Dr
Newark, DE 19702-5942
Phone (302) 235-9159

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1649791922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 BROOKFIELD DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025942",
            "telephone_number": "302-235-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 BROOKFIELD DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025942",
            "telephone_number": "302-235-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD RESILIENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "JUAREZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "302-235-9159",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "2017603208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.