Individual provider Active NPI

Lawrence Alfred Avitabile

  • Professional Counselor
  • Oradell, NJ
National Provider Identifier
1730478207
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00081400 Issued in NJ
Practice address
70 Elizabeth St
Oradell, NJ 07649-2607
Phone
(201) 289-7077
NPI assigned
Apr 5, 2011
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00081400 NJ Primary

Addresses

Primary practice location

70 Elizabeth St
Oradell, NJ 07649-2607

Mailing address

70 Elizabeth St
Oradell, NJ 07649-2607
Phone (201) 289-7077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107003059 NJ Practitioner - Mental Health Counselor 6204331903 Practice locations: Oradell, NJ

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Oradell, NJ 07649
Phone (210) 289-7077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37PC00081400NJMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1730478207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 ELIZABETH ST",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076492607",
            "telephone_number": "201-289-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 ELIZABETH ST",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076492607",
            "telephone_number": "201-289-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVITABILE",
        "first_name": "LAWRENCE",
        "middle_name": "ALFRED",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00081400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oradell, NJ

Sources for this page

Verify at the official NPI Registry.