Icbh

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ICBH

Practice address

130 Maple Ave Ste WB2
Red Bank, NJ 07701-1736

Phone

(732) 668-4460

NPI assigned

Dec 20, 2022

Organization subpart

No

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

Authorized official

Name

Clarissa Mulligan Attara, PHD, LPC, LCADC, ACSNPI 1033788583

Title

Counselor, Supervisor, Educator

Phone

(732) 668-4460

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Clarissa Mulligan Attara, PHD,LPC,LCADC,LMHC

  • Professional Counselor
  • Lawrenceville, NJ
  • NPI 1033788583
  NPD Authorized official

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1770295941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR",
            "address_2": "# 6722",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281702",
            "telephone_number": "732-668-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MAPLE AVE STE WB2",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011736",
            "telephone_number": "732-668-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICBH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-20",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "MULLIGAN ATTARA",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_title_or_position": "COUNSELOR, SUPERVISOR, EDUCATOR",
        "authorized_official_telephone_number": "732-668-4460",
        "authorized_official_credential": "PHD, LPC, LCADC, ACS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0450874979",
            "identifier": "0450874979",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geralyn Marie Hyland, RD,CDE
• Cindy Hyman, LCSW
• David Hyppolite, M.D.
• Matthew Iacoviello
• Iain Ro Associates LLC
• Jacklyn Lillian Ignizio, NURSE PRACTITIONER
• Philip V Ilaria, M.D.
• Jaehyuck Patrick Im, MD
• Robert Nick Incitti, PT OCS CSCI
• Brian R Incremona, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.