Courtney Facendo, LSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

44SL06213900 Issued in NJ

Practice address

1466 Hooper Ave
Toms River, NJ 08753-2892

Phone

(848) 218-0790

Fax

(732) 358-0829

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

No

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

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Integrated Care Concepts & Consultation, LLC

  • Professional Counselor
  • Eatontown, NJ
  • NPI 1639236516
  Medicare reassignment NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1790215069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 CROOKED STICK RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274032",
            "telephone_number": "848-218-0790",
            "fax_number": "732-358-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532892",
            "telephone_number": "848-218-0790",
            "fax_number": "732-358-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACENDO",
        "first_name": "COURTNEY",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL06213900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Obinna Ezealor, APN PMHNP-BC
• Ezmedsupply LLC
• Janine Fabrizio
• Michael Facciolli, RNFA
• Karissa Facciponte
• Colleen Fagan
• Ayman A. Faheem, MD
• Marlaina Elizabeth Fairthorne, OTR/L
• Angela E Falastin, O.D.
• Angelo Louis Falcone, PHARMACIST

• Mental Health Counselor in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.