Shobha Ayyappan, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00595000 Issued in NJ

Practice address

2130 Millburn Ave Ste D1
Maplewood, NJ 07040-3749

Phone

(201) 259-1890

NPI assigned

Apr 28, 2018

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

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

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Mountain Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Millburn, NJ
  • NPI 1952939944

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524873600000",
    "number": "1770071359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GLEN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411722",
            "telephone_number": "201-259-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE STE D1",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403749",
            "telephone_number": "201-259-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYYAPPAN",
        "first_name": "SHOBHA",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-28",
        "last_updated": "2018-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00595000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolene Auguste, APN
• Aunjuli a. Hicks LPC Limited Liability Company (Hicks Group: Wellness Center)
• Avedamed LLC
• Kalavathi Ayyagari, M.D.
• Kamalakar R. Ayyagari, M.D.
• Kira Baskerville-Williams, LCSW
• Ruby Baskerville, LCSW
• Bass Family Chiropractic, PC
• Michelle Bass, LCSW
• Wayne Jonathan Bass, DC

• Professional Counselor in Maplewood, NJ
• Providers in Maplewood, 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 Apr 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.