NPIMap

Organization Active NPI

Mental Health Assn of Essex and Morris

  • Mental Health Counselor
  • Montclair, NJ
National Provider Identifier
1699942391
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
302090405 Issued in NJ
Legal business name
MENTAL HEALTH ASSN OF ESSEX AND MORRIS
Practice address
33 S Fullerton Ave
Montclair, NJ 07042
Phone
(973) 509-9777
Fax
(973) 509-9218
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Authorized official

Name
Robert N Davison, MA LPC
Title
Executive Director
Phone
(973) 509-9777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 302090405 NJ Primary
Case Management Agency 251B00000X 302090405 NJ

Addresses

Primary practice location

33 S Fullerton Ave
Montclair, NJ 07042

Mailing address

33 S Fullerton Ave
Montclair, NJ 07042-3358
Phone (973) 509-9777

Other identifiers 1

IdentifierTypeStateIssuer
0017744MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Assn of Essex and Morris10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533513600000",
    "number": "1699942391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S FULLERTON AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423358",
            "telephone_number": "973-509-9777",
            "fax_number": "973-509-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 S FULLERTON AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "07042",
            "telephone_number": "973-509-9777",
            "fax_number": "973-509-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH ASSN OF ESSEX AND MORRIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2018-08-06",
        "status": "A",
        "authorized_official_last_name": "DAVISON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-509-9777",
        "authorized_official_credential": "MA LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "302090405",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NJ",
            "license": "302090405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017744",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.