Kelly M Seccamanie

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

License

14392 Issued in FL

Practice address

1 Mountain Boulevard
Executive Plaza Suite 201
Warren, NJ 07059

Phone

(908) 507-0455

Fax

(908) 580-9745

NPI assigned

Oct 19, 2010

Last updated

Oct 19, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1689984007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 BAKER AVE",
            "city": "BERKELEY HTS",
            "state": "NJ",
            "postal_code": "079221302",
            "telephone_number": "908-507-0455",
            "fax_number": "908-580-9745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MOUNTAIN BOULEVARD",
            "address_2": "EXECUTIVE PLAZA SUITE 201",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "07059",
            "telephone_number": "908-507-0455",
            "fax_number": "908-580-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECCAMANIE",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "FL",
            "license": "14392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pastoral Counselor in Warren, NJ
• Providers in Warren, NJ by specialty
• Pastoral Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.