George Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00672400 Issued in NJ

Practice address

25 Vreeland Rd # a
Florham Park, NJ 07932-1902

Phone

(973) 966-9200

NPI assigned

Apr 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659909836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GRAY ST",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067605",
            "telephone_number": "862-400-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 VREELAND RD # A",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321902",
            "telephone_number": "973-966-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00672400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310015",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "ManageHealthCarAssociates",
            "affiliation": "Y",
            "address_1": "25 Vreeland Rd # A",
            "city": "Florham Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "079321902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.