Insightful Mind Counseling Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00511900 Issued in NJ

Legal business name

INSIGHTFUL MIND COUNSELING SERVICES, LLC

Practice address

36 Midvale Rd
Lower Level 5
Mountain Lakes, NJ 07046-1353

Phone

(973) 750-4111

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Roy Stephan Corson, M.ED., L.P.C., N.C.CNPI 1689065815

Title

Owner/ Clinician

Phone

(973) 750-4111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roy Stephan Corson, M.ED., L.P.C., N.C.C

  • Mental Health Counselor
  • Kinnelon, NJ
  • NPI 1689065815
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1740654417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MIDVALE RD",
            "address_2": "LOWER LEVEL 5",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461353",
            "telephone_number": "973-750-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MIDVALE RD",
            "address_2": "LOWER LEVEL 5",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461353",
            "telephone_number": "973-750-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIGHTFUL MIND COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "CORSON",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "STEPHAN",
        "authorized_official_title_or_position": "OWNER/ CLINICIAN",
        "authorized_official_telephone_number": "973-750-4111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED., L.P.C., N.C.C"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00511900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Mountain Lakes, NJ
• Providers in Mountain Lakes, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.