Vivian Jean Deetjen, BA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

S-4121 Issued in NJ

Practice address

492 Route 57 West
Family Guidance Center of Warren County
Washington, NJ 07882

Phone

(908) 689-1000

Fax

(908) 589-4529

NPI assigned

Feb 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699802074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 KNERR DRIVE",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "18062",
            "telephone_number": "908-454-5741",
            "fax_number": "908-213-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 ROUTE 57 WEST",
            "address_2": "FAMILY GUIDANCE CENTER OF WARREN COUNTY",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "07882",
            "telephone_number": "908-689-1000",
            "fax_number": "908-589-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETJEN",
        "first_name": "VIVIAN",
        "middle_name": "JEAN",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "S-4121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Washington, NJ
• Providers in Washington, 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 Jul 8, 2007; 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.