Active NPI
Sam Cruset Harairy
- Mental Health Counselor
- North Bergen, NJ
National Provider Identifier
1659190403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 37AC00810300
- Practice address
- 6713 Bergenwood Ave
North Bergen, NJ 07047-3732 - Phone
- (443) 422-0117
- NPI assigned
- Oct 8, 2024
- Sex
- Male
- 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 | 37AC00810300 | NJ | Primary |
Addresses
Primary practice location
6713 Bergenwood Ave
North Bergen, NJ 07047-3732
Mailing address
6713 Bergenwood Ave
North Bergen, NJ 07047-3732
Phone (443) 422-0117
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00810300 | NJ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1659190403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6713 BERGENWOOD AVE",
"city": "NORTH BERGEN",
"state": "NJ",
"postal_code": "070473732",
"telephone_number": "443-422-0117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6713 BERGENWOOD AVE",
"city": "NORTH BERGEN",
"state": "NJ",
"postal_code": "070473732",
"telephone_number": "443-422-0117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARAIRY",
"first_name": "SAM",
"middle_name": "CRUSET",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-08",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37AC00810300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bergen, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.