Vito Andrisani, MA, CJC, CCS, LCADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Haledon, NJ
NPI 1679915425 · NPPES record last updated Jul 22, 2013
Key facts
- NPI
- 1679915425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 37LC00053200 (NJ)
- Practice address
- 32 Richard Scott Court
Haledon, NJ 07508-1707 - Phone
- (862) 203-9469
- NPI assigned
- Jul 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 493
Pompton Lakes, NJ 07442
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260212001392 | NJ | Practitioner - Mental Health Counselor | 8820479454 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00053200 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bring Hope | Current |
Accepting new patients | |
| Bring Hope | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Vava Consulting Services | Past |
Accepting new patients |
Locations
400 Ramapo Ave
Pompton Lakes, NJ 07442
Phone (973) 858-8163
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00053200 | NJ | Yes |
Addresses
Primary practice location
32 Richard Scott Court
Haledon, NJ 07508-1707
Mailing address
32 Richard Scott Court
Haledon, NJ 07508-1707
Phone (862) 203-9469
Other providers in Haledon, NJ
- Maria Alfakir
- Mariyam Ali
- All in One, LLC
- Grisel Almonte
- Ama Adult Daycare Health Center Inc
- Angels Care Medical Transportation Inc
- Angels Care NJ LLC
- Anyway Medical Transportation,Inc
- Aris RX Inc
- Art Medical Supply Inc
All providers in Haledon, NJ · Addiction (Substance Use Disorder) Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.